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Assessment of portal venous index as a non-invasive method for diagnosing liver fibrosis in patients with chronic hepatitis C

DOI: 10.1590/S0004-28032012000100004

Keywords: hepatitis c, chronic, liver cirrhosis, portal vein, ultrasonography, ultrasonography.

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Abstract:

context: hepatitis c is an important cause of chronic liver disease worldwide. the grading of hepatic fibrosis in chronic hepatitis c is important for better clinical management. however, until now, liver biopsy is the only test accepted for this purpose, despite their contraindications and complications. new methods for non-invasive assessment of hepatic fibrosis are under investigation. one proposal is the doppler ultrasound, as a non-invasive, widely available and inexpensive. objective: to compare doppler parameters of portal vein in patients with chronic hepatitis c with a healthy control group and to correlate these parameters with fibrosis degree obtained by liver biopsy. methods: fifty patients with chronic hepatitis c submitted to liver biopsy and 44 healthy controls had doppler of the portal vein performed, with the calculation of the portal venous index. we conducted a comparison between the averages of the two groups of portal venous index. for the correlation between portal venous index and fibrosis was employed the spearman test. results: there was a difference between the average portal venous index between controls (0.33 ± 0.07) and patients (0.23 ± 0.09) with p<0.001. no difference was observed between the portal venous index in patients with chronic hepatitis c who have significant fibrosis or not. the correlation between the portal venous index and fibrosis degree was reverse and moderate (r =-0.448 p<0.001). the area under the roc curve was 78.4% (95% ci: 68.8% to 88%). the cutoff for the portal venous index was 0.28 with sensitivity of 73.5% and specificity of 71.1%. conclusion: the portal venous index was useful in distinguishing healthy patients from patients with chc. however, there was no significant difference in the quantification of degree of fibrosis.

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