Ultrasound imaging features in primary biliary cholangitis

Abstract Background The aim of our study was to analyze the characteristics of ultrasound images corresponding to each histological stage of primary biliary cholangitis (PBC). Methods We prospectively analyzed 75 confirmed cases of PBC and used liver biopsy as the gold standard to determine disease stage. Results The typical ultrasound images of PBC patients were characterized by a thickening of the portal vein wall (PVW) and periportal hypoechoic band (PHB) width with increasing histological stages, and significant increases in the left hepatic lobe diameter (LHLD) in stage II (by 64.0%) and stage III (by 69.2%). PHB width (r = 0.857, p < 0.001), PVW thickness (r = 0.488, p < 0.001), and spleen area (r = 0.8774, p < 0.001) were positively correlated with histological stage. Significant changes were noted in the liver surface, liver echogenicity, and liver edge between different stages. Conclusions Ultrasound imaging characteristics of PBC patients varied according to the histological staging. LHLD, PVW thickness, and PHB width were significantly correlated with the histological stage. A combination of high- and low-frequency ultrasound imaging can provide relevant cues on the degree of PBC progression and important clinical reference values.