Correlation between hepatic ultrasound and histology

Objective: To correlate findings in routine departmental hepatic ultrasound examinations with histological findings at liver biopsy. Design: Retrospective comparison of ultrasound findings and histology assessed independently by different observers. Setting: Patients admitted to teaching hospital for liver biopsy. Patients, participants: 102 patients admitted for liver biopsy who had hepatic ultrasound examinations within a few days of biopsy. Main outcome measures: Sensitivity and specificity of ultrasound examination compared with histology. Results: Including patients with mild non-specific fatty changes on histology, ultrasound had a sensitivity and specificity of 95% and 37%, respectively, for detecting normal livers. Ultrasound was highly specific for detecting fatty change but sensitivity was poor for mild fatty change compared with moderate/severe fatty change (24% versus 81%). Ultrasound was similarly specific (85%) for fibrosis or cirrhosis but less sensitive (31%). 80% of alcoholic liver disease patients had an abnormal though not necessarily diagnostic scan. Conclusions: A normal ultrasound by no means excludes parenchymal liver disease, while an abnormal scan is strong evidence of significant pathology. Ultrasound examination is less sensitive than liver biopsy in assessing the degree of hepatic fibrosis.