الفهرس 
Introduction & aim of the workOnly 14 pages are availabe for public view
 |  | from | 134 |  |  |
| | | from | 134 | | |
Abstract
Cirrhosis is defined as fibrosis of the liver with the formation of regenerative nodules. Once a liver has been scarred to the point of cirrhosis, it will probably never return to normal. The diagnosis of cirrhosis is traditionally established with biopsy results, but it can often be suggested at imaging. Radiological evaluation of clinical severity of liver cirrhosis, tendencies of EV bleeding, early prediction of hepatorenal syndrome and portosystemic collaterals by US with duplex Doppler and CT. This study included 40 patients, 28 males and 12 females. Their age ranged from 40 to 63 years with mean age of 54.5 years. Patients proved clinically and laboratory to have post hepatitic liver cirrhosis, and studied after upper GIT endoscopy. All patients were come from internal medicine department. Also from the outpatient of internal medicine, general surgery and Gastroenterology center of Mansoura University Hospital during the period from February 2005 to October 2005. criteria for exclusion included; diabetes mellitus, renal disorders and vitally unstable patients . (R( (BClinical assessment: (R( (BTrans abdominal US by transducer of 512MHz. (R( (BUS with duplex Doppler study of the haemodynamics of the liver , spleen and kidneys. (R( (BDual phase CT for evaluation of the modified C/RLr ratio . By gray scale US 28 of 40 of patients had course and nodular echopatteren represents 70%. And the surface nodularity was positive in 37 of 40 patients (92.5%), monophasic and biphasic wave in the hepatic veins seen in 35of 40 patients (87.5?%). The platelet count to splenic long axis ratio wear in the EV patients ranging from 34,000 to 200,000/cmm, while in non esophageal varices group the platelet number ranging from 80,000 to 250,000/cmm. BY duplex Doppler in cirrhotic group PVV. it ranges from 9 to 31cm/sec, while in child B and C it ranging from 8 to18, 7 to 17cm/sec respectively . The composite parameter with biological plausibility (that is, the platelet count/spleen diameter ratio) showed a high accuracy for noninvasively predicting the presence of EV in patients with either compensated or decompensated liver cirrhosis. The platelet count/spleen diameter ratio seems to represent an acceptable surrogate for clinically relevant portal hypertension. Patients with hepatic cirrhosis shows that the echostructural features of the liver parenchyma at the time of diagnosis can provide valuable information about the patient<U+2019>s risk for HCC. The coarse nodular pattern can be observed in almost all etiologic forms of cirrhosis. Duplex Doppler could be used as noninvasive technique in prediction of severity of liver cirrhosis and presence of esophageal varices by measurements of hepatic and renal homodynamics. Duplex Doppler examination is a safe and reproducible technique for evaluating arterial blood flow, and it has been extensively validated as an indicator of renal vasoconstriction in various pathologic conditions, including liver cirrhosis. C/RLm ratio could be used as sensitive and specific predictor of clinical severity. In conclusion US with duplex Doppler and CT are important imaging modalities in: (R( (BEvaluation of clinical severity of liver cirrhosis . (R( (BPrediction of the presence of EV. (R( (BEarly prediction of renal prenchymal affection (HRS) in liver cirrhosis. (R( (BModified C/RLr lobe ratio is an effective parameter in evaluation of severe liver cirrhosis .