Evaluation Of The Stages Of Liver Fibrosis In Patients With Chronic Hepatisis Using Color Doppler Ultrasonography

Liver fibrosis is consecutive to extra cellular matrix deposition and inflammation in liver with end stage of liver cirrhosis and high mobility and fatality in China. Liver biopsy, the current"gold-standard"to estimate liver fibrosis , is a costly procedure with adverse effects feared by patients and clinicians. Color Doppler ultrasonic examination has been using as non-invasive-test alternative to liver biopsy. The early investigation of liver fibrosis with Color Doppler ultrasonic examination will help us enormously to better appreciate the ongoing process of fibrosis leading to cirrhosis on one hand and the process of reversibility of fibrosis on the other hand.We compared the result of Color Doppler ultrasonic examination with staging of pathological liver fibrosis of 138 patients who were diagnosed chronic hepatitis. To discuss the diagnostic value of Color Doppler ultrasonic examination in patients with liver cirrhosis and the relation with different stage of liver fibrosis.138 patients (14-72 year's old)with chronic hepatitis B, diagnosed in China-Japan union hospital affiliated to Jilin university.110 male,28 female .20 healthy person,13 male and 7 female were selected。All subjects were detected by Antraus Ultrasonoraphic machine of Siemens Company and Sonosope SSI-1000 of Kaili Company. in the series, 168 patients with chronic hepatitis B were undertaken liver biopsy and Color Doppler ultrasonic examination for determination of diameter of portal vein, the maximum blood flow velocity of portal vein and hepatic artery, ratio of maximum blood flow velocity of hepatic artery and portal vein, the portal venous blood flow, the hepatic circulation index, the waveform changes of hepatic vein. Data were comparatively analyzed with staging of pathological liver fibrosis. All dates are statistically analyzed with statistical software package SPSS13.0. According to the type of dates, applying T-test, Chi-square Test.No complication happened in all cases underwent liver biopsy.S0:20cases,S1:35cases,S2:31cases,S3:32cases,S4:28cases.With the development of hepatitis ,diameter of portal vein, he maximum blood flow velocity of hepatic artery increased, while the maximum blood flow velocity of portal vein increased , there is statistically significant between S4 and other phases,. but no differences among S0,S1,S2,S3.There is no statistically significant in volume of portal vein among all phases,S0,S1,S2,S3,S4.Ratio of maximum blood flow velocity of hepatic artery and portal vein, the hepatic circulation index were parallel with the degree of liver fibrosis. For the ratio of maximum blood flow velocity of hepatic artery and portal vein, the hepatic circulation index, There were significant differences between mild(S0-S1), medium(S2-S3), and severity phases.The waveforms of hepatic vein were divided into three types as HV0, HV1, and HV2. HV1 and HV2 were considered abnormal while HV0 normal. There is statistically significant in waveform of hepatic vein between S4 and other phases, but no differences among S0, S1, S2, and S3.Ultrasonography is playing a important role in the examination for the advantages because of being convenient, repeatable and non-invasive. in the series, 138 patients with chronic hepatitis B were undertaken liver biopsy and Color Doppler ultrasonic examination for determination of diameter of portal vein, the maximum blood flow velocity of portal vein and hepatic artery, ratio of maximum blood flow velocity of hepatic artery and portal vein, the portal venous blood flow, the hepatic circulation index, the waveform changes of hepatic vein. Data were comparatively analyzed with staging of pathological liver fibrosis.The changes of diameter of portal vein, he maximum blood flow velocity of portal vein and hepatic artery, ratio of maximum blood flow velocity of hepatic artery and portal vein, the hepatic circulation index, the waveform of hepatic vein were parallel with the degree of liver fibrosis. For the ratio of maximum blood flow velocity of hepatic artery and portal vein ,the hepatic circulation index, There were significant differences between mild(S0-S1), medium(S2-S3), and severity phases. For the other indexes, there were significant differences between S4 and other phases, but no differences among S0, S1, S2, S3.In conclusion, the Color Doppler ultrasonography has a definite value in the diagnosis of liver fibrosis in the patients with chronic liver disease. The ratio of maximum blood flow velocity of hepatic artery and portal vein, the hepatic circulation index are more definite and sensitive.