Role of hepatic Doppler as compared to Fibro-scan in evaluation of post virus C hepatic fibrosis

Abstract

The liver is the largest organ in the body , which is divided into right and left lobes and further subdivided into eight independent functional segments , each segment has its own portal and hepatic blood flow . Three hepatic veins drain the liver into IVC . Hepatitis c virus infection has acute stage which presented within 14 days or may take 6 months to produce any signs and chronic stage, as hepatitis progress fibrosis develops which lead to cirrhosis and serious complications develop. Hepatic fibrosis is a response of the wound healing of the liver due to repeated injury that cause inflammation of the liver and replacement of normal hepatocytes by ECM , in advanced stage the liver contain ECM 6times more than normal . Liver fibrosis is the main predictor of the progression of chronic hepatitis C, and its assessment by liver biopsy can help determine therapy. However, biopsy is an invasive procedure with several limitations. A noninvasive medical device based on transient elastography (fibroscan®)has been used to measure liver stiffness the results are expressed in kpa and interpreted as a METAVIR score which incorporate 5 stages of fibrosis F0,F1,F2,F3,F4. yet fibroscan has some limitations .