Diagnostic Accuracy of Hepatic Vein Resistive Index in Detection of Hepatic Fibrosis in Patients of Chronic Liver Disease

  • Sidrah Nadeem
  • Sana Wasim
  • Sidrah Manzoor
  • Hareem Ata
  • Riffat Raja
  • Sadaf Arooj
Keywords: Diagnostic accuracy, chronic liver disease, hepatic vein resistive index, hepatic fibrosis.

Abstract

Introduction: If we could prove the diagnostic accuracy of hepatic vein resistive index in detecting liver fibrosis in chronic liver disease patients, this would be beneficial for the patients as it is a non-invasive, readily available, and cost-effective technique for the diagnosis of liver fibrosis. This will help the physicians in the early initiation of definitive management.

Materials and Methods: Seventy-five (n=75) patients with hepatitis B aged between 18-50 years were enrolled. Hepatic vein resistive index and liver biopsy were performed in even-patients. Sensitivity, Specificity, PPV, NPV, and overall accuracy of the hepatic vein resistive index was calculated.

Results: Average age group studied was  38y ± 8.2 SD. 57.3 % (N=43) were males and 42.7% (n=32) patients were females respectively. Data of this work Exhibits various statistical indicators 77%. 96.7%. 97.2%. 74.3% and 85.3% respectively.

Conclusion: Hepatic vein resistive index measured by ultrasonography can detect liver fibrosis in CLD with overall sensitivity, Specificity, PPV, NPV, and accuracy of 77.7%. 96.7%. 97.2%. 74.3% and 85.3% respectively.

References

1. Kim MY, Baik SK, Jeong WK. Invasive and non invasive diagnosis of cirrhosis and portal hypertension. World J Gastroenterol. 2014;20:4300-15.
2. Siddiqui EH, Shah N, Siddiqui S. Ultrasound; Evaluation of hepatobiliary system. Professional Med J. 2012;19:187-92.
3. Lefton HB, Rosa A, Cohen M. Diagnosis and epidemiology of cirrhosis. Med Clin North Am. 2009;93:787–99.
4. Iwaisako K, Brenner DA, Kisseleva T. What’s new in liver fibrosis? The origin of myofibroblasts in liver fibrosis. J Gastroenterol Hepatol. 2012;27:65-8.
5. Novo E, Cannito S, Paternostro C, Bocca C, Miglietta A, Parola M. Cellular and molecular mechanisms in liver fibrogenesis. Arch Biochem Biophys. 2014;548:20–37.
6. Friedman SL. Molecular regulation of hepatic fibrosis, an integrated cellular response to tissue injury. J Biol Chem. 2000;275:2247–50.
7. Mallat A, Lotersztajn S. Cellular mechanisms of tissue fibrosis. 5. Novel insights into liver fibrosis. Am J Physiol Cell Physiol. 2013;305:C789–C799.
8. Maclachlan JH, Cowie BC. Hepatitis B virus epidemiology. Cold Spring Harb Perspect Med. 2015;5:a021410.
9. Hamed MA, Ali SA. Non-viral factors contributing to HCC. World J Hepatol. 2013;5:311–22.
10. Montuclard C, Hamza S, Rollot F, Evrard P, Faivre J. Causes of death in people with chronic hepatitis B virus infection: A population-based cohort study. J Hepatol. 2015;62:1265-71.
11. Ramos-Lopez O, Martinez-Lopez E, Roman S, Fierro NA, Panduro A. Genetic, metabolic and environmental factors involved in the development of liver cirrhosis in Mexico. World J Gastroenterol. 2015;21:11552-66.
12. Roman S, Ojeda-Granados C, Ramos-Lopez O, Panduro A. Genome-based nutrition: an intervention strategy for the prevention and treatment of obesity and nonalcoholic steatohepatitis. World J Gastroenterol. 2015;21:3449–61.
13. Aceves D, Ruiz B, Nuño P, Roman S, Zepeda E, Panduro A. Heterogeneity of apolipoprotein E polymorphism in different Mexican populations. Hum Biol. 2006;78:65–75.
14. Ignee A, Gebel M, Caspary WF, Dietrich CF. Doppler imaging of hepatic vessels - review. Z Gastroenterol. 2002;40:21-32.
15. Allan R, Thoirs K, Phillips M. Accuracy of ultrasound to identify chronic liver disease. World J Gastroenterol. 2010;16:3510-20.
16. Lutz HH, Gassler N, Tischendorf FW, Trautwein C, Tischendorf JJ. Doppler ultrasound of hepatic blood flow for noninvasive evaluation of liver fibrosis compared with liver biopsy and transient elastography. Dig Dis Sci. 2012;57:2222-30.
17. Iwao T, Toyonaga A, Oho K, Tayama C, Masumoto H, Sakai T, et al. Value of Doppler ultrasound parameters of portal vein and hepatic artery in the diagnosis of cirrhosis and portal hypertension. Am J Gastroenterol. 1997;92:1012-7.
18. Abbattista T, Ridolfi F, Ciabattoni E, Marini F, Bendia E, Brunelli E, et al. Diagnosis of liver cirrhosis by transit-time analysis at contrast-enhanced ultrasonography. Radiol Med. 2008;113:860-74.
19. Tang A, Kim TK, Heathcote J, Guindi M, Jang HJ, Karshafian R, et al. Does hepatic vein transit time performed with contrast-enhanced ultrasound predict the severity of hepatic fibrosis? Ultrasound Med Biol. 2011;37:1963-9.
20. Kamal MM, Niazi M, Umar M. Sensitivity and Specificity of Ultrasonography in the Early Diagnosis of Liver Fibrosis Stage in Patients with Chronic Liver Disease. Ann Pak Inst Med Sci. 2009; 5: 237-41
Published
2020-09-29
How to Cite
1.
Nadeem S, Wasim S, Manzoor S, Ata H, Raja R, Arooj S. Diagnostic Accuracy of Hepatic Vein Resistive Index in Detection of Hepatic Fibrosis in Patients of Chronic Liver Disease. JRMC [Internet]. 29Sep.2020 [cited 22Oct.2020];24(3):278-82. Available from: http://journalrmc.com/index.php/JRMC/article/view/1482