Objectives: To investigate distorted liver by movement of diaphragm during full inspiration and to find usefulness of ultrasound for assessing liver fibrosis or cirrhosis
Materials and Methods:
19 patients (control group) and 24 patients with liver cirrhosis (Child A) were included in this study. Cirrhosis were and subdivided arbitrary into early cirrhosis (N=13) and overt cirrhosis (N=11). Two sagital images of left hepatic lobe were obtained during resting state and full inspiration with Valsalva maneuver by transabdominal ultrasound. Length between inferior hepatic angle and midpoint of liver dome was measured in all images. The changes of left lobe length in two images were calculated for evaluating hepatic distortion. The calculated lengths were compared between each groups.
Results:
The mean left lobe lengths were 8.3±1.1cm (resting) vs. 9.0±1.3cm (inspiratory), respectively, in cirrhotic group and 8.6 ±1.5 cm vs. 10.5 ±1.5 cm, respectively, in control group. The cirrhotic group has significantly lower mean change of left lobe length than control group (0.7±0.9 cm vs. 1.9±0.9 cm, respectively, p<0.05). In patients with cirrhosis, patients with early cirrhosis has significantly higher change of left lobe length than patients with overt cirrhosis (1.4±1.1 cm vs. 0.2±0.6 cm, respectively, p<0.05).

Conclusion:
The sonographic finding such as less change of left lobe length (stiffer) during full inspiration may aid in diagnosis of cirrhosis and in discrimination between the different stages of fibrosis.