Ultrasound Markers in Early Diagnosis of Asymptomatic Chronic Hepatitis. A Prospective Study

Introduction: Nowadays, chronic viral hepatitis represents one of the most common pathological entities with over 400 million cases worldwide, with high diagnosis and treatment cost, severe complications in late stages and an annual death-rate around 1 million. The purpose of this study was to identify noninvasive ultrasound markers in order to establish an early diagnosis in asymptomatic chronic hepatitis. Methods: We enrolled in a prospective study 111 patients diagnosed with asymptomatic chronic hepatitis: 53 patients with hepatitis B (group A) and 58 patients with hepatitis C (group B). All patients underwent ultrasound exam; we evaluated the dimensions of the left hepatic lobe, right hepatic lobe, caudate lobe, portal vein, liver stiffness, presence of hepatic hilar lymph nodes, number and dimensions of the adenopathies. Results: Increased liver size was found in over 16% of patients in group A and over 20% of patients in group B. We registered an enlarged portal vein in 3.77% of patients in group A and in 3.45% of patients in group B. Adenopathies were found in 64.16% of group A and 82.76% of group B. Using long adenopathic axis as marker, we obtained a NPV over 0.9, PPV of 0.5 in the detection of chronic hepatitis B and a PPV of 0.9 in the detection of chronic hepatitis C in asymptomatic patients, a specificity of 0.98 for both chronic hepatitis B and C, a sensitivity of 0.81 for group B and 0.64 for group A. Conclusions: The presence of hilar liver adenopathies represents an important marker in detecting asymptomatic chronic viral hepatitis.