COMPARISON OF ULTRASONOGRAPHIC PICTURES WITH PERITONEOSCOPIC FINDINGS OF THE LIVER SURFACE IN DIAGNOSIS OF LIVER DISEASES

Abstract

Ultrasonography has been proven to be useful in evaluating the liver diseases. Some of reports have commented on the parenchymal echogram of the liver, however only a few have been published in which analysis was made of the reliability of the liver surface echograms. Retrospective evaluations were performed of abdominal ultrasonographies in 135 patients who underwent peritoneoscopy to analyze the liver surface echogram in dignosis of liver disease. Peritoneoscopic findings were expressed using Shimada's code number system. Liver surface echograms were classified into five patterns : Pattern I (thin and straight line), pattern II (thin and dotted line), pattern III (thick and blurred line), pattern V (uneven parallel dotted line) and pattern IV (wavy line). The results were : (1) Most of cases with smooth liver surface (peritoneoscopically, diagnosed as Shimada's code No. 100 or 200) showed pattern I or II in liver surface echogram. (2) No fixed pattern was obtained in cases with block formed liver surface (code No. 300). (3) Most of cases with nodular liver surface (code No. 400 or 500) showed pattern III, although the cases with micronodular cirrhosis, of which nodules being 1-2mm in diameter showed pattern I or II. Three of four cases with pattern IV or V were accompanied with ascites. On the other hand, only one case with macronodular cirrhosis, of which nodules being over 5mm in diameter, was not accompanied with ascites. (4) Results of evaluation for ability of ultrasonography to distinguish smooth liver surface from nodular liver surface were : Sensitivity, specificity and overall accuracy in liver cirrhosis being 73%, 88% and 84%, respectively.