Analysis of the hepatic echo pattern in chronic hepatitis C.

Aim: Patients with chronic hepatitis C often present a bright echopattern of the liver. Our aim was to examine the relationship of the sonographic echotexture of the liver in relation to the histological findings in patients with chronic hepatitis C without cirrhosis. Methods: The livers of 68 patients with chronic hepatitis C (40 male, 28 female, age: 39+/-9 years) were evaluated by high resolution ultrasound equipment (3,5 and 5 MHz). Histologic specimens were obtained at the same time. Grading and staging was performed according to the histological activity index. 70 healthy subjects (40 male, 30 female, age: 35 +/- 9 years, no histology) were examined as controls. Results: A bright sonographic echotexture of the liver was found in 26/68 (38 %) patients with chronic hepatitis C, which correlated with the degree of fatty infiltration in the liver. Other parameters of the histological activity index showed no significant correlation with the echotexture of the liver. Hypoechoic areas in the liver hilus were detected in 24/26 (92 %) patients with chronic hepatitis C and a bright echotexture of the liver. In 6/70 (9%) healthy subjects a bright sonographic echotexture could be detected. Conclusion: Patients with chronic hepatitis C typically show a bright echotexture of the liver, which correlates mainly with the histological finding of fatty infiltration. A hypoechoic lesion next to the liver hilus is present in almost all patients with bright echotexture of the liver and is a sonographic sign of fatty infiltration of the liver, which might represent an area of less fat content and/or more fibrous tissue which could be due to different vasculature.