الفهرس 
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Abstract
This descriptive study was conducted to evaluate how Grey scale and color Doppler ultrasonography might be useful in non-invasive evaluation of chronic viral hepatitis and compensated early cirrhosis in patients referred to the diagnostic radiology department of Suez Canal University Hospital, in Ismailia. Forty patients positive for hepatitis C serum markers who had recent needle biopsy were enrolled into the study
The mean age of the patients was 45.05 ± 11.4 years. There was higher frequency of male patients among the studied population (M/F=52.5%/47.5%). No history of cardiac diseases or alcohol consumption among the studied patients, while 35% of them had history of previous operations.
Mean liver size of the studied patients was 15.55 ± 2.09 cm. The majority of patients had smooth hepatic outline (75%) and echogenic hepatic parenchyma (60%). Mean spleen size of the studied patients was 12.9 ± 3.4cm. Mean portal vein diameter, AR, peak velocity, VTAM and CI were 1.2±0.2 mm, 1.3±0.42 cm2, 26.7±9.9 cm/sec, 14.07±4.5 cm/sec and 0.1±0.06; respectively. Mean hepatic artery VTAM and RI were 15.5±7.25cm/sec and 0.73±0.09; respectively.
The majority of patients had histopathological stages of 0-4 (fibrosis; 75%) and the rest of them had histopathological stages of 5-6 (cirrhosis; 25%)
Cirrhotic patients had significantly higher mean age than fibrotic patients (54.2 years versus 42 years, respectively) (p<0.05). There was no statistically significant difference between both groups regarding sex (p>0.05).
Cirrhotic patients had significantly higher mean splenic size than fibrotic patients (16.2 cm versus 11.8 cm, respectively) (p<0.05). Cirrhotic patients had significantly higher frequency of irregular hepatic outline and coarse hepatic parenchyma than fibrotic patients (80% and 80% versus 6.7% and 13.3%, respectively) (p<0.05).There was no statistically significant difference between both groups regarding liver size (p>0.05).
Cirrhotic patients had significantly higher mean portal vein diameter, AR, peak velocity, VTAM and CI than fibrotic patients (p<0.05). Cirrhotic patients had significantly higher mean A/P ratio, FI and SAPI than fibrotic patients (p<0.05). There was no statistically significant difference between both groups regarding mean hepatic artery VTAM and RI (p>0.05).
The results showed that the AUC, as measured by ROC curve, was significantly high in portal vein diameter, AR, CI, A/P ratio, FI and SAPI differentiating fibrosis from cirrhosis using colour Doppler. It also shows that the sensitivity and specificity, as measured by ROC curve, were significantly high in portal vein diameter, AR, CI, A/P ratio, FI and SAPI differentiating fibrosis from cirrhosis using colour Doppler.
IN CONCLUSION:
o Gray scale and Doppler Ultrasonography can accurately and non-invasively assess liver hemodynamics and differentiate fibrotic from cirrhotic patients.