Ultrasound Evaluation of Liver in Patients Who Had History of Hepatitis C

Background : Hepatitis is an infection of liver. The disorder can be self-limiting or lead to fibrosis(scarring), cirrhosis, or liver cancer. Both acute infection and chronic sequelae, such as hepatitis C, cause significance morbidity and mortality in the hum of population. Hepatitis can be very contour in 37.5%, nodularity in 42.9% and vascular changes in 58.9%. Conclusion : Some extent of hepatitis C diseases cannot be seen on CT or MRI but can be seen on grey scale ultrasonography due to its high resolution .so, it can be concluded that the grey scale ultrasonography is more efficient and authentic diagnostic equipment in assessing the liver hepatitis C as compared to the CT. of our study is to evaluate the liver parenchyma in patients with history of hepatitis C and to provide descriptive data to prevent future liver pathologies. The major goal of our study is to slow or even reverse the progression of liver fibrosis and to prevent development of liver related complication and histologic Changes in the liver prior to Analyze the factors associated with histological Changes. Grey scale ultrasonography has been reported to detect ultrasonographic features of chronic disease resulting in decreased liver function and ultimately, liver failure and to help the patients with cured hepatitis C to check out the parenchymal damage and to give them a healthy lifestyle. detecting HCV RNA in plasma, and who had not Previously receiving anti-hepatitis C drugs. This study concluded that treatment before a CVA procedure. We excluded patients who had been infected with hepatitis B virus (HBV) or human immunodeficiency virus (HIV) and who had a history of alcohol abuse or abstinence from alcohol. Muscle, or mitochondrial antibodies, and had a significant elevation of liver enzymes. Amr Shaaban Hanafy and others conducted a research study that included patients infected with chronic hepatitis virus (n = 180) and 60 healthy people as a control group, all of whom matched their age, gender, and body mass index. Based on clinical, laboratory, ultrasound and Fibro Scan functions. Eligible patients were diagnosed with cirrhosis secondary to hepatitis C virus infection which was demonstrated by positive testing for hepatitis C virus and HCV-RNA in serum, and they were divided into two groups: Group 1 which included 90 patients with EV-complicated liver cirrhosis. And group 2, which included 90 cases of cirrhosis. Patients without EV. Group 3 consists of controls. George N. Ioannou performed a study of 48,151 patients with hepatitis C-related cirrhosis (HCV) in the National Veterans Health Administration who had at least 3 years of follow-up after a diagnosis of cirrhosis. This study concluded that Patients were identified by performing at least one positive HCV RNA test between January 1, 2000 and January 1, 2016, and were followed up with a diagnosis of cirrhosis on January 1, 2019, in order to develop an HCC incident.


Result:
56 patients were included in our study out of which 27 were females and 29 were males. The ultrasonographic findings of the patients having liver hepatitis C shows the cirrhosis in 44.6%, change in liver contour in 37.5%, nodularity in 42.9% and vascular changes in 58.9%.

Discussion:
It was a retro prospective analysis in which 56 patients of liver hepatitis C are involved. Ali Mansoor conducted a study to determine the diagnostic accuracy of ultrasound to predict the presence of cirrhosis induced by hepatitis C .their study concluded that there was no association between the gender.137 were male 63 were female . The overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of doppler ultrasound for predicting the presence of hepatitis C were 88.98%,89.04%,93.00%,82.28%and 89.00%, respectively.
Antonietta Romano conducted a study to assess the incidence of newly diagnosed liver cancer and associated risk factors in patients with advanced hepatitis C who were treated with DAA, a potential registration database for all patients with hepatitis C. exclusion criteria were: child-Turcotte-Pugh-C, liver transplantation prior to DAA, history of presence of HCC, follow up less than 4 weeks after initiation of DAAs. This study concluded that a total of 29% of HCC patients had a violent tumor, often presenting in the early stage of treatment.
In our study the ultrasonography shows the cirrhosis in 44.6%, changes in liver contour in 37.5%, portal hypertension in 57.1%, nodularity in 42.9%, liver parenchymal changes in 51.8% and vascular changes in 58.9%. Pierre nahon conducted a research study to investigate the effect of sustained virological response (SVR) on the outcome of patients with hepatitis C and compensated cirrhosis. We collected information from 1,323 patients selected for accompanying viral cirrhosis (CirVir) from the National Agency for Research and Impending Viral Hepatitis (ANRS), selected from 35 clinical centers from 2006 to 2012. All patients were affected by viral hepatitis and cirrhosis. This study concluded that Metabolic characteristics have been associated with an increased risk of HCC in patients with SVR, but not in patients with viremia. Similar results were obtained in a population identical to the degree of propensity. Toshikuni Suda conducted a study to investigate hepatitis C and patients with sustained viral response (SVR). Among them, 136 patients were infected with hepatitis C patients did not receive antiviral treatment and 51 patients received antiviral treatment. Takahisa Sato retrospectively reviewed that ultrasound is the most frequently used method for monitoring chronic HCC in patients with chronic hepatitis C. A total of 243 nave HCC cases were detected among 1,431 patients with chronic hepatitis C in the outpatient setting. HCC was first detected by ultrasound in 221 patients. Cirrhosis patients were likely to be interviewed at shorter periods. Tumor size exceeded 30 mm in only three cases (1.4%). This study concluded that Ultrasound surveillance over a period of six months was generally appropriate for identifying HCC of less than 30 mm.
Our study concluded that ultrasonography was more efficient diagnostic equipment in assessing the liver hepatitis C as compared to CT and MRI. A study represented by Tomasz Cieciuraa included 120 patients (43 (35.83%) women and 77 (64.17%) men), according to the HCV genotype: 109 (90.8%) G1 patients, 8 (6.7%) with G3 and 3 (2.5%) with G4. In group G1, the G1b subtype was diagnosed in 101 patients and G1a in one patient. In 7 cases, there was no sub gene analysis. The mean age of the patients was 58.8 (IQ: 48.6-63.2) years, and the mean time after LTX was 92.7 (IQ: 59.8-124.5) months. In the study group, 76 patients (63.3%) had a history of previous interferon treatment failure. There was another study conducted by Siri nawasatien conducted this study by reviewing medical records of all criteria for chronic hepatitis C inclusion from patients over the age of 18 years who were diagnosed with hepatitis C virus by detecting HCV RNA in plasma, and who had not Previously receiving anti-hepatitis C drugs. This study concluded that treatment before a CVA procedure. We excluded patients who had been infected with hepatitis B virus (HBV) or human immunodeficiency virus (HIV) and who had a history of alcohol abuse or abstinence from alcohol. Muscle, or mitochondrial antibodies, and had a significant elevation of liver enzymes. Amr Shaaban Hanafy and others conducted a research study that included patients infected with chronic hepatitis virus (n = 180) and 60 healthy people as a control group, all of whom matched their age, gender, and body mass index. Based on clinical, laboratory, ultrasound and Fibro Scan functions. Eligible patients were diagnosed with cirrhosis secondary to hepatitis C virus infection which was demonstrated by positive testing for hepatitis C virus and HCV-RNA in serum, and they were divided into two groups: Group 1 which included 90 patients with EV-complicated liver cirrhosis. And group 2, which included 90 cases of cirrhosis. Patients without EV. Group 3 consists of controls. George N. Ioannou performed a study of 48,151 patients with hepatitis C-related cirrhosis (HCV) in the National Veterans Health Administration who had at least 3 years of follow-up after a diagnosis of cirrhosis. This study concluded that Patients were identified by performing at least one positive HCV RNA test between January 1, 2000 and January 1, 2016, and were followed up with a diagnosis of cirrhosis on January 1, 2019, in order to develop an HCC incident.
According to our study ultrasonography was the most efficient tool in detecting the liver hepatitis C because the cirrhosis, liver parenchymal changes, nodularity, portal hypertension and vascular changes were found more efficient on grey scale ultrasonography and also helpful in the detection of other types of liver disease that are associated with the liver

Conclusion:
Some extent of hepatitis C diseases cannot be seen on CT or MRI but can be seen on grey scale ultrasonography due to its high resolution .so, it can be concluded that the grey scale ultrasonography is more efficient and authentic diagnostic equipment in assessing the liver hepatitis C as compared to the CT.