A new procedure for noninvasive determination of histological activity index in the diagnostic algorithm for patients with chronic viral hepatitis

Objective. To develop a procedure for noninvasive determination of a histological activity index in patients with chronic viral hepatitis. Subjects and methods. 16 (13 absolute and 3 relative) indicators were recorded in 124 patients with chronic hepatitis B and C at abdominal ultrasonography. Liver biopsy specimens from all the patients were histologically examined, by determining the degree of fibrosis using the METAVIR scale. The investigators carried out a multivariate regression analysis of the findings, by using its incremental algorithm and excluding the input variables that included all recorded ultrasound indicators and patients’ age. Results. The analysis showed that it was possible to create a diagnostic model encompassing 5 ultrasound indicators: sectional area of the left liver lobe (mm2); width of the spleen (mm); sectional area of the spleen (mm2); diameter of the hepatic artery (mm); mean velocity of portal vein blood flow (cm/sec). Conclusion. The proposed noninvasive procedure allows determination of a histological activity index in patients with chronic viral hepatitis without resorting to histological verification with a diagnostic prognostic value of at least 95%.

histological activity index, chronic viral hepatitis, ultrasonography, biopsy