To Determine the Diagnostic Accuracy of Doppler Waveform Pattern of Hepatic Veins in Detection of Chronic Liver Disease in hepatitis C patients Keeping Histopathology as gold Standard

Abstract

INTRODUCTION:Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most important cause of chronic liver disease in Pakistan.  The diagnosis of cirrhosis is of great prognostic value and requires liver biopsy for further management. The structural changes in cirrhosis lead to abnormal wave form in hepatic veins.OBJECTIVES:

To determine the diagnostic accuracy of the Doppler waveform pattern of hepatic veins in detection of cirrhosis in HCV positive patients based upon histopathology as gold standard.

STUDY DESIGN:

Descriptive Cross-sectional

DURATION and SETTING:

Conducted at P.N.S Shifa, naval hospital Karachi from 27-01-2014 to 26-07-2014

SUBJECTS AND METHODS:

152 patients were included in the study. Doppler examination of hepatic veins was performed followed by liver biopsy. Hepatic wave form patterns were divided into normal triphasic pattern and abnormal biphasic/monophasic patterns and were analyzed by comparing with histopathology reports.

RESULTS:

Doppler waveform pattern of hepatic veins showed sensitivity (75.61%), specificity (92.79%), diagnostic accuracy (88.15%), positive predictive value (79.49%) and negative predictive value (91.15%) for detection of cirrhosis.

CONCLUSION:

It was concluded from the results of this study that non invasive Doppler waveform pattern of hepatic veins have high diagnostic accuracy and, negative predictive value in the detection of cirrhosis in hepatitis C patients.

KEY WORDS:

Viral Hepatitis; Cirrhosis; positive predictive value, waveform pattern of hepatic veins, histopathology

Dr Nisar Ahmed, Dr Rahat Shahid, Dr Shehla Tanveer, Dr Mazhar Shafique, Dr Atif Latif. PNS Shifa, Karachi, Pakistan.