Purpose
We aimed to present three new ultrasound signs—gallbladder scalloping, mammillated
caudate lobe, and inferior vena cava scalloping—and determine their accuracy in diagnosing
liver cirrhosis.
Materials and Methods
A total of 201 consecutive patients with a history of chronic liver disease who had
undergone ultrasound imaging and liver biopsy were identified. A senior ultrasound
radiologist blindly reviewed the ultrasound examinations. Specificity, sensitivity,
positive predictive value, and negative predictive value of diagnosing cirrhosis were
calculated for all evaluated ultrasound signs and selected combinations of signs,
using the liver biopsy results as the reference standard.
Results
Of the 201 patients, 152 (76%) had either pathology-proven cirrhosis or significant
fibrosis. Caudate lobe hypertrophy was the most specific (88%) and most positive predictor
(90%) for cirrhosis, whereas mammillated caudate lobe was the most sensitive (78%).
Inferior vena cava scalloping was the most specific (78%) of the three proposed ultrasound
signs. When signs were combined, the presence of either gallbladder scalloping or
liver surface nodularity was highly sensitive for cirrhosis (87%), whereas the presence
of either gallbladder scalloping or inferior vena cava scalloping with caudate lobe
hypertrophy was highly specific (93%).
Conclusions
Gallbladder scalloping, mammillated caudate lobe, and inferior vena cava scalloping
are three novel signs that improve the accuracy of ultrasound in diagnosing cirrhosis.
Key Words
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Article info
Publication history
Published online: March 27, 2018
Accepted:
February 3,
2018
Received in revised form:
January 30,
2018
Received:
December 5,
2017
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
