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Sonographic Findings of the Hepatobiliary-Pancreatic System in Adult Patients With Cystic Fibrosis

Medizinische Klinik II (C.F.D., M.C., T.O.H., J.B., T.O.W., B.L.) and Zentrum der Kinderheilkunde (P.L.), Johann Wolfgang Goethe-Universität, Frankfurt/Main, Germany.

Address correspondence and reprint requests to Christoph F. Dietrich, MD, Caritas-Krankenhaus Bad Mergentheim, Innere Medizin 2, Uhlandstrasse 7, D-97980 Bad Mergentheim, Germany.

Objective. Sonography of the liver, biliary system, and pancreas in adult patients with cystic fibrosis is by far less systematically documented than in pediatric patients with cystic fibrosis. In this prospective study, duplex sonographic findings of the liver, biliary system, and pancreas in adult patients with cystic fibrosis were compared with those of healthy control subjects. Methods. Seventy-two consecutive patients with cystic fibrosis and 60 healthy control subjects were examined by high-resolution sonography. The incidence of perihepatic lymphadenopathy, the hepatic echo pattern, the detection rate of liver tumors, the flow patterns in the hepatic and portal veins, and pathologic gallbladder and pancreas findings were recorded. Additionally, cholestasis-indicating enzyme levels (-glutamyl transpeptidase and alkaline phosphatase), liver function test results (alanine aminotransferase and aspartate aminotransferase levels), and amylase and lipase levels were recorded as well. Results. Patients with cystic fibrosis, when compared with healthy subjects on sonographic examination, had a higher incidence of microgallbladder (25% versus 0%) and cystic lesions of the pancreas (18% versus 0%). The number of abnormal echo patterns of the liver was increased (46% versus 15%), with a higher incidence of a nontriphasic flow pattern in the right hepatic vein. The differences proved to be statistically significant (P < .05). Conclusions. Typical sonographic findings in adult patients with cystic fibrosis are a microgallbladder and small cystic lesions of the pancreas. Pathologic findings of the liver can be shown by B-mode and duplex sonography, but the resulting patterns are less characteristic.

Abbreviations: CF, cystic fibrosis

Key Words: sonography • cystic fibrosis • liver • cholestasis • cystic disease

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