Sonography is a noninvasive and inexpensive procedure for
diagnosis of diffuse liver disease; however, the value of sonography for
distinguishing a low degree of liver fibrosis from cirrhosis is limited. In a
study by Colli et al, 28 of 107 patients with severe fibrosis or definite
cirrhosis (26%) had negative results for liver surface nodularity and caudate lobe hypertrophy and had normal hepatic venous flow.
In this regard, elastography integrated into ultrasound systems is an effective
adjunctive tool for quantifying liverfibrosis.
Conclusions
In patients with chronic viral hepatitis, particularly in patients
with hepatitis C virus infection, all noninvasive methods are ready to be used
for detecting and staging liver fibrosis before therapy at a safe level of
predictability.
As with transient elastography, elastographic techniques based
on shear waves generated by the acoustic beam are more accurate in detecting
cirrhosis than significant fibrosis. They have the advantage of B-mode
guidance, which allows one to choose an area of liver parenchyma better suited
for stiffness assessment (ie, free of large vessels and focal lesions).
These methods are all valid when information about fibrosis
is needed. Liver biopsy should still be performed when biochemical tests and
imaging studies are inconclusive or information other than liver fibrosis is
required.
Không có nhận xét nào :
Đăng nhận xét