Acoustic Liver Biopsy in Patients with Hepatitis C and Advanced Liver Fibrosis Using Endoscopic Ultrasound.

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Dig Dis Sci. 2011 Apr 1. [Epub ahead of print]

Acoustic Liver Biopsy in Patients with Hepatitis C and Advanced Liver Fibrosis

Using Endoscopic Ultrasound.

Vegesna A, Nazir A, Chung CY, Kane S, R, L.

Department of Medicine, Section of Gastroenterology, Temple University Hospital,

8th Floor Parkinson Pavillion, Philadelphia, PA, 19140, USA,

dranilraju@....

Abstract

BACKGROUND: Transabdominal ultrasound cannot be used to quantitate fibrosis in

patients with advanced liver fibrosis due to variability in the abdominal wall

thickness and composition. This variability can be eliminated by using

endoscopic ultrasound.

AIM: The purpose of this study was to determine the amount of fibrosis in the

liver of hepatitis C patients with advanced fibrosis using endoscopic

ultrasound.

METHODS: Endoscopic ultrasound images of the liver were recorded by keeping the

gain, contrast, frequency, magnification and acoustic power constant on the

ultrasound processor. Videotaped images of the liver were digitized on Image-Pro

Plus software. Using adobe Photoshop, a histogram was produced to quantitate the

luminosity of the five areas of interest per image. Quantification of the

ultrasound images were done by two independent investigators blinded to the

Ishak liver fibrosis score. The mean luminosity of the ultrasound images were

compared with the Ishak fibrosis score. The study was performed in seven

patients (mean age 54 years; 3 male, 4 female) with hepatitis C and advanced

liver fibrosis.

RESULTS: The correlation between the two independent investigators for the

ultrasound images was 0.93. The correlation between the mean luminosity on

ultrasound images to the Ishak fibrosis score was r = 0.77, r = 0.72 and r =

0.73 for the most hyperechoic area of interest, total hyperechoic area and for

the entire liver, respectively.

CONCLUSION: A new technique was developed that uses endoscopic ultrasound to

evaluate the degree of fibrosis in patients with advanced liver fibrosis. There

is a good correlation between the luminosity on endoscopic ultrasound and the

Ishak fibrosis score.

PMID: 21455673 [PubMed - as supplied by publisher]