만성 간질환 환자에서 간표면 초음파검사의 의의

Abstract

PURPOSE : To evaluate the diagnostic value of sonographic irregularities of liver surface in thedifferentiation of chronic liver disease. MATERIAL & METHODS : Fifty-eight patients with either chronic hepatitisor early stage of liver cirrhosis were examined with 5 MHz linear array transducer by observing the liver surface.We compared the sonographic findings with peritoneoscopic and pathologic findings. Thirty-five patients withsmooth surface showed variable pathological results, including chronic active and persistent hepatitis, inactivehepatitis and alcoholic hepatitis without any evidence of cirrhosis. Nineteen patients with micronodules mostlyrevealed chronic active hepatitis and cirrhosis. All 4 patients with macronodules were proved pathologically ascirrhosis RESULT : High resolution ultrasonography(HRUS) showed smooth liver surface in 35 patients(60.3%),micronodular surface in l9(32.8%), and macronodular surface in4 (6.9%). Twenty-one cases(60.0%) among 35 patientswith smooth surface were peritoneoscopically normal and 12 cases(34.3%) showed dimpling surface. However among l9patients with micronodular surface, only 5 cases(26.3%) showed micronodular surface on peritoneoscopy. while 8cases(42.l%) showed nracronodular surface and 6 cases(3l.6%) dimpling surface. All 4 patients with macronodulesrevealed peritoneoscopically nracronodular surface. CONCLUSlON : Observation of liver surface by HRUS was usefulin predicting the progression of chronic hepatitis to cirrhosis. However, it was not helpful in thedifferentiation between normal liver and chronic hepatrtrs.