Sang Wook Shin1, Tae Yeob Kim2, Woo Kyoung Jeong1,3, Yongsoo Kim1, Jinoo Kim1,4, Young Hwan Kim5, Hwan Cheol Park2, Joo Hyun Sohn2. 1. Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea. 2. Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea. 3. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea. 4. Department of Radiology, Ajou University Hospital, Ajou University College of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380, Korea. 5. Nuclear Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomoon-dong, Guri-si, Gyeonggi-do, 471-701, Korea.
Abstract
BACKGROUND: To investigate B-mode and Doppler ultrasonography (US) features correlating with laboratory findings for the diagnosis of severe acute hepatitis (SAH) in patients with hepatitis A virus infection. METHODS: Thirty-nine consecutive serologically proven patients were enrolled. Decreased parenchymal echotexture, periportal tracking, gallbladder wall change, and splenomegaly were assessed on B-mode images. Blood flow velocities were measured in the main portal (V(PORTAL)) and in the hepatic veins, and the hepatic venous pulsatility index was calculated. SAH was defined as high model for end-stage liver disease (MELD) score ≥ 15 with or without coagulopathy. The relationship between US features and laboratory findings was assessed, and SAH diagnosis was evaluated. RESULTS: Serum alanine transaminase and prothrombin time were significantly different depending on the presence of gallbladder wall change and splenomegaly (p < 0.05). V(PORTAL) was inversely correlated with MELD score (r = -0.485) and several laboratory markers. The hepatic venous waveform and hepatic venous pulsatility index were significantly correlated with MELD score. For the diagnosis of SAH, the area under the receiver operating characteristic curve of V(PORTAL) was 0.798. It reached 0.869 in the patients with typical GB change. CONCLUSIONS: Both B-mode and Doppler US correlated well with several laboratory variables and may be helpful to diagnose SAH in patients with hepatitis A virus infection.
BACKGROUND: To investigate B-mode and Doppler ultrasonography (US) features correlating with laboratory findings for the diagnosis of severe acute hepatitis (SAH) in patients with hepatitis A virus infection. METHODS: Thirty-nine consecutive serologically proven patients were enrolled. Decreased parenchymal echotexture, periportal tracking, gallbladder wall change, and splenomegaly were assessed on B-mode images. Blood flow velocities were measured in the main portal (V(PORTAL)) and in the hepatic veins, and the hepatic venous pulsatility index was calculated. SAH was defined as high model for end-stage liver disease (MELD) score ≥ 15 with or without coagulopathy. The relationship between US features and laboratory findings was assessed, and SAH diagnosis was evaluated. RESULTS: Serum alanine transaminase and prothrombin time were significantly different depending on the presence of gallbladder wall change and splenomegaly (p < 0.05). V(PORTAL) was inversely correlated with MELD score (r = -0.485) and several laboratory markers. The hepatic venous waveform and hepatic venous pulsatility index were significantly correlated with MELD score. For the diagnosis of SAH, the area under the receiver operating characteristic curve of V(PORTAL) was 0.798. It reached 0.869 in the patients with typical GB change. CONCLUSIONS: Both B-mode and Doppler US correlated well with several laboratory variables and may be helpful to diagnose SAH in patients with hepatitis A virus infection.