Perihepatic nodes detected by point-of-care ultrasound in acute hepatitis and acute-on-chronic liver disease

doi:10.3748/wjg.v21.i44.12620

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Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/29746

Title:	Perihepatic nodes detected by point-of-care ultrasound in acute hepatitis and acute-on-chronic liver disease
Authors:	Feng, I. Che Wang, Szu Jen Sheu, Ming Jen Koay, Lok-Beng Lin, Ching Yih Ho, Chung Han Sun, Chi Shu Kuo, Hsing Tao
Contributors:	老人服務事業管理系
Keywords:	Point-of-care ultrasonography Perihepatic lymph node Acute on chronic hepatitis B Acute hepatitis A Acute hepatitis flare
Date:	2015-11
Issue Date:	2016-04-19 19:06:43 (UTC+8)
Publisher:	Baishideng Publishing Group Inc
Abstract:	AIM: To study the manifestations of perihepatic lymph nodes during the episode of acute hepatitis flare by point-of-care ultrasonography. METHODS: One hundred and seventy-six patients with an episode of acute hepatitis flare (ALT value > 5 x upper normal limit) were enrolled retrospectively. Diagnosis of etiology of the acute hepatitis flare was based on chart records and serological and virological assays. The patients were categorized into two groups (viral origin and non-viral origin) and further defined into ten subgroups according to the etiologies. An ultrasonograpy was performed within 2 h to 72 h (median, 8 h). The maximum size of each noticeable lymph node was measured. Correlation between clinical parameters and nodal manifestations was analyzed RESULTS: Enlarged lymph nodes (width >= 5mm) were noticeable in 110 (62.5%) patients, mostly in acute on chronic hepatitis B (54.5%). The viral group had a higher prevalence rate (89/110 = 80.9%) and larger nodal size (median, 7 mm) than those of the non-viral group (21/66 = 31.8%; median, 0 mm) (p < 0.001 for both). Meanwhile, there were significant differences in the nodal size between acute and chronic viral groups (p < 0.01), and between acute hepatitis A and non-hepatitis A viral groups (p < 0.001). In logistical regression analysis, the nodal width still showed strong significance in multivariate analysis (p < 0.0001) to stratify the two groups. The area under the curve of ROC was 0.805, with a sensitivity of 80.9%, a specificity of 68.2%, positive predictive value of 80.92%, negative predictive value of 68.18%, and an accuracy of 76.14%. CONCLUSION: Point-of-care ultrasonography to detect perihepatic nodal change is valuable for clarifying the etiologies in an episode of acute hepatitis flare.
Relation:	World Journal of Gastroenterology, v.21 n.44, pp.12620-12627
Appears in Collections:	[Dept. of Senior Service and Health Management] Periodical Articles

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