Steinmaurer H J, Jirak P, Walchshofer J, Clodi P H
Ultraschall Med. 1984 Jun;5(3):98-103. doi: 10.1055/s-2007-1012076.
A prospective study has been carried out on 127 patients to test the accuracy of sonography in the diagnosis of diffuse liver diseases compared with histology based on percutaneous liver biopsy. Using sonographic criteria - size, margin, surface, elasticity, echo structure and sonic conductivity of the liver, hepatic veins and portal vein - and measuring the size of the gallbladder and the spleen, the following sonographic diagnoses were made: normal liver, fatty liver, fatty liver fibrosis, alcoholic hepatitis, chronic active hepatitis, cirrhosis. Sonographic diagnosis predicted histological diagnosis in case of normal liver in 56%, fatty liver 70%, alcoholic hepatitis 92%, chronic active hepatitis 63%, cirrhosis 79%. The specificity of sonography was 95%, the overall sensitivity was 82%: e.g. fatty liver 84%, chronic active hepatitis 93% and cirrhosis 79%. We conclude that sonography is an ideal screening method for detecting diffuse liver diseases. In cases of fatty liver and of cirrhosis it can spare the patient further invasive investigation. Furthermore, this method is suitable for evaluating the course of diffuse diseases of the liver, especially of toxic-nutritive liver damage and also of chronic active hepatitis.
对127例患者进行了一项前瞻性研究，以检验超声检查在诊断弥漫性肝病方面的准确性，并与基于经皮肝活检的组织学检查结果进行比较。利用超声检查标准——肝脏、肝静脉和门静脉的大小、边缘、表面、弹性、回声结构和声波传导性，并测量胆囊和脾脏的大小，做出了以下超声诊断：正常肝脏、脂肪肝、脂肪性肝纤维化、酒精性肝炎、慢性活动性肝炎、肝硬化。超声诊断对正常肝脏组织学诊断的预测准确率为56%，脂肪肝为70%，酒精性肝炎为92%，慢性活动性肝炎为63%，肝硬化为79%。超声检查的特异性为95%，总体敏感性为82%：例如，脂肪肝为84%，慢性活动性肝炎为93%，肝硬化为79%。我们得出结论，超声检查是检测弥漫性肝病的理想筛查方法。对于脂肪肝和肝硬化患者，它可以避免患者接受进一步的侵入性检查。此外，该方法适用于评估肝脏弥漫性疾病的病程，尤其是中毒性营养性肝损伤以及慢性活动性肝炎的病程。
