The diagnosis of liver fibrosis lesions remains an important issue in patients with chronic
liver diseases. The early detection of fibrosis is important for determining disease
progression and postponing the evolution of chronic hepatitis into cirrhosis via the
implementation of prompt and specific treatment. However, as chronic liver disease can remain
asymptomatic for a long time, numerous cirrhotic patients are diagnosed belatedly, when
life-threatening complications start appearing.
Noninvasive methods for liver fibrosis diagnosis have been developed over the last decade. In
this setting, blood fibrosis tests and transient elastography have been shown to be accurate,
and are now commonly used as first-intention tests for liver fibrosis diagnosis in chronic
liver diseases. However, these tests are usually performed by a hepatologist to whom the
patient has been referred following the appearance of symptoms suggestive of chronic liver
disease. Thus the number of patient diagnosed early by these new tools, that is in the period
before symptoms start appearing and during which preventative measures may be particularly
beneficial, remains quite low in relation to the prevalence of the disease. This prevalence
has been estimated to 0.5 to 2.8 % in general population.
Many studies have identified the value of hemodynamic and morphological ultrasound parameter
in providing information on liver fibrosis degree. Moreover, abdominal ultrasound is widely
used for various symptoms, and thus could be an excellent way to detect patients with signs
evoking liver fibrosis or cirrhosis, who could then be referred to a liver specialist for
confirmation of the diagnosis by blood fibrosis tests and/or transient elastography. To be
feasible during a nonspecific US examination, and by any radiologist, these signs should be
easy and quick to collect. Addition of a quick measure of hepatic stiffness could increase
the screening interest of ultrasound examination.
The main aim of the present study was thus to validate 3 simple US signs in patients referred
for ultrasound abdominal examination for reasons other than suspicion of liver disease.