Sensitivity of Ultrasound in Diagnosis of Type A Viral Hepatitis

Abstract

Background: Type A viral hepatitis (Hepatitis A) is an acute infectious liver disease caused by Hepatitis A virus (HAV) and is strongly associated with poor sanitation and fecal–oral transmission. Although serological testing remains the gold standard for diagnosis, ultrasonography is widely used as a supportive, non-invasive imaging tool, especially in resource-limited settings. Objective: To evaluate the sensitivity of ultrasonography in the diagnosis of Type A viral hepatitis and to assess its characteristic clinical, laboratory, and imaging findings. Methods: This cross-sectional study was conducted over three months at the Department of Diagnostic Radiology & Imaging, Nishtar Medical University and Hospital. A total of 47 patients with suspected acute viral hepatitis were initially enrolled, and 30 patients met the inclusion criteria based on serological confirmation of HAV infection. Data were collected through structured questionnaires, clinical evaluation, laboratory investigations, and abdominal ultrasonography using an Apollo 7 (2018 model) machine with a curvilinear probe. SPSS version 24 was used for data analysis. Results: The majority of patients were young adults (10–40 years), with a slightly higher proportion of females. The most common clinical features included jaundice (97.8%), dark urine (93.6%), abdominal pain (80.8%), and fever (80.8%). Laboratory findings showed markedly elevated ALT (565.7 ± 585.1 IU/L), AST (647.3 ± 608.4 IU/L), and bilirubin levels (5.3 ± 3.2 mg/dL), indicating significant hepatocellular injury. On ultrasonography, gallbladder wall thickening (85.1%) was the most frequent finding, followed by starry sky appearance (70.2%), pericholecystic edema (59.5%), and hepatomegaly (42.5%). Ascites and pleural effusion were less common. Conclusion: Ultrasonography demonstrates good sensitivity in detecting characteristic hepatic and biliary changes in acute Hepatitis A infection, particularly gallbladder wall thickening and periportal changes. However, due to its low specificity, it should be used as a complementary diagnostic tool alongside clinical assessment and serological testing. It is particularly valuable in resource-limited settings for early evaluation and supportive diagnosis of acute viral hepatitis.