Hepatitis D ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]; João André Alves Silva, M.D. [3] Jolanta Marszalek, M.D. [4]
Overview
The ultrasound may be used as a screening tool in patients with chronic hepatitis D, for the early detection of hepatic cirrhosis. Attending to the concomitant existence of HDV and HBV, HBsAg carriers with cirrhosis should be echographically evaluated every 6 months.[1]
Ultrasound
The following findings may be identified in patients with hepatitis D:[1][2][3][4]
- Hepatomegaly (acute phase)
- Irregular thickening of the gallbladder wall, often due to inflammation and edema (more frequent in hepatitis A)
- Increased echogenicity
- Segmental hypertrophy with nodular appearance of the liver
- Portal hypertension:
- Splenomegaly
- Ascites
- Pleural effusion
- Reversed flow
In advanced stages of the disease, in which cirrhosis might be present, the following findings may be identified:
HBsAg carriers should have regular serial serum alpha-fetoprotein determinations. Ultrasound examinations should be performed in patients above 40 years of age (with 6 month intervals). These tests should be repeated regularly in all HBsAg carriers with cirrhosis.[1]
Ultrasound is also useful for the diagnosis and monitoring of hepatocellular carcinoma, a potential complication of hepatitis D.
References
- ↑ 1.0 1.1 1.2 "Hepatitis D" (PDF).
- ↑ Ferral H, Male R, Cardiel M, Munoz L, Quiroz y Ferrari F (1992). "Cirrhosis: diagnosis by liver surface analysis with high-frequency ultrasound". Gastrointest Radiol. 17 (1): 74–8. doi:10.1007/BF01888512. PMID 1544561.
- ↑ Kok T, van der Jagt EJ, Haagsma EB, Bijleveld CM, Jansen PL, Boeve WJ (1999). "The value of Doppler ultrasound in cirrhosis and portal hypertension". Scand J Gastroenterol Suppl. 230: 82–8. PMID 10499467.
- ↑ Tchelepi H, Ralls PW, Radin R, Grant E (2002). "Sonography of diffuse liver disease". J Ultrasound Med. 21 (9): 1023–32, quiz 1033-4. PMID 12216750.