Ultrasound Assessment of Early Chronic Liver Disease

Pamela Parker1, Nimah M Sahib2, Louise Alcock1, Linda Sunman1, 1Ultrasound, Hull and East Yorkshire Hospitals NHS Trust, 2School of Life Sciences, Hull York Medical School,

Liver disease is an increasing problem world-wide and liver disease is the only major cause of death still increasing year-on-year.  Liver disease often starts with fatty infiltration of the normal liver tissue. Left untreated this can progress to fibrosis and cirrhosis. Severe cirrhosis can lead to the development of hepatic cellular carcinoma and a very poor prognosis. Often, the process is silent, but when liver disease has developed and presents as an acute illness it has a 25-50% immediate mortality rate.

Commonly the first diagnosis of liver disease is through ultrasound imaging where the increased fat in the liver is detected. Ultrasound imaging is a relatively cheap and simple first line investigation. Significant fatty infiltration can be diagnosed. However, it can be very difficult to determine the extent of fatty infiltration and therefore the significance of this. This can lead to an under or over diagnosis of this common but potentially life changing condition. New machine technologies have helped in lesion detection but the traditional diagnostic features of the ultrasound imaging that aided diagnosis of fatty liver disease have changed these parameters. This has led to an inconsistency between ultrasound operators in their diagnosis of fatty liver disease.

The aim of this project is to evaluate the agreement between operators in the diagnosis of fatty liver disease.

25 sets of images of previously reported fatty livers have been reviewed retrospectively. 20 operators with a range of experience from 1 – 30 years have scored the images. The scores will be compared and any variability between reviews will be assessed. This poster presents the results of this local inter and intra-operator review of this common but significant finding.

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