(Ultrasound Review) For children with cystic fibrosis, CT and ultrasound correlation enabled improved diagnosis of fat infiltration and periportal fibrosis and increased diagnostic accuracy. The finding, reported in the January issue of European Journal of Radiology, suggested that although ultrasound is the most commonly used diagnostic tool for hepatobiliary manifestations in cystic fibrosis, the improved diagnostic capabilities of CT and ultrasound in combination enabled enhanced patient management and follow-up.
Dr Deniz Akata and colleagues from Hacettepe University School of Medicine, Ankara, Turkey, performed ultrasound and CT in 48 children, and compared the results. Thirty children had at least one abnormal liver finding on either CT or ultrasound. While ultrasound showed increased liver echogenicity in 24 patients, only 12% of these were confirmed as steatosis using CT attenuation criteria.
"Liver echogenicity was considered increased if it was significantly greater than that of the right kidney. Fat infiltration, fibrosis and microcalcifications all manifest as increased echogenicity on ultrasound and are therefore difficult to differentiate. Ultrasound showed increased periportal echogenicity in 37% of patients that CT failed to identify," they said.
Other findings detected by both modalities were cirrhosis, lymph nodes at the hepatico-duodenal ligament (37%), and gallbladder abnormalities (24%). Liver enlargement, contour irregularity and heterogeneous parenchyma characterized parenchymal disease. None of the children with cirrhosis showed any collateral venous dilation usually associated with portal hypertension.
"The most common radiological finding was increased echogenicity of the liver, found in 24 (50%) of the patients which was heterogeneously increased in seven and homogeneously increased in 17 patients," the authors said.
Akata and colleagues concluded, "none of the imaging methods were superior, but supplementary of each other." Improved management of lung disease affords cystic fibrosis patients extended survival rates, which in turn requires refined diagnosis of hepatobiliary disease. This should enable better determination of patient prognosis, they said.
"Hepatobiliary manifestations of cystic fibrosis in children: correlation of CT and US findings"D Akata et al
Department of Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
European Journal of Radiology 2002(January); 41:26-31
By Ultrasound Review
January 3, 2002
Copyright © 2002 AuntMinnie.com
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&fit=crop&h=100&q=70&w=100)
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
