Non-Invasive Assessment Of Liver Fibrosis By Simple Doppler Ultrasound Parameters

Research Article
Marcel W Keddeas., Nevine I Musa ., Sara M Abdelhakam and Remon Zaher Elia
Liver fibrosis, non-invasive, Doppler, hepatic vein waveform, hepatic artery resistance index, splenic artery resistance index.

Background and Aim: Doppler ultrasonography of hepatic vasculature might indirectly reflect histological alteration, namely liver fibrosis. This study aimed to assess different Doppler parameters which might non-invasively predict the stage of liver fibrosis. Methods: 55 patients with HCV related chronic liver disease were included. They were divided into: Group I: 32 patients with chronic hepatitis C without cirrhosis and Group II: 23 patients with cirrhosis (Child A). All were subjected to clinical evaluation, laboratory investigations, abdominal ultrasonography, Doppler for evaluation of hepatic artery resistance index (HARI), splenic artery resistance index (SARI) and hepatic vein (HV) waveform and percutaneous liver biopsy (for Group I only) with fibrosis staging according to METAVIR score. Results: HV waveform was an accurate parameter for predicting significant fibrosis and cirrhosis as it showed the highest degree of agreement with METAVIR score. The best cutoff value of HARI was (> 0.74) for predicting cirrhosis (F4) and significant fibrosis (F ≥ 2). HARI was proved to be more sensitive and specific than SARI to predict cirrhosis (F4). Conclusion: Doppler ultrasonography, especially HV waveform analysis, may non-invasively predict liver fibrosis stage.