Abstract: Background: Chronic hepatitis C is a slowly progressive disease that can be classified as mild, moderate or severe according to liver histology. The present study was conducted to assess role of sonography in predicting steatosis and fibrosis in chronic hepatitis C patients.

Materials & Methods: 58 cases of HCV positive of either gender underwent USGtaken with SSA-250A system, Toshiba, Tokyo, Japan. A 3.75-MHz sector transducer without harmonic image was utilized for the conventional US study. All underwent a percutaneous liver biopsy to stage CHC prior to anti-HCV pretreatment assessment.

Results: Out of 58 cases, 32 were males and 26 were females.Hepatic steatosis grade 0 was seen in 38, I in 14, II in 6 patients. Inflammation-necrosis gradeI in 5, II in 42, III in 11 cases. Fibrosis stage I in 21, II in 33 and III in 3 patients. The difference was significant (P< 0.05). Sensitivity, specificity, PPV and NPV in patients with Steatosis > 5% found to be 72%, 73%, 59% and 83% respectively. In patients with steatosis > 30%, it was 86%, 61%, 13% and 94% respectively.

Conclusion: Gray-scale US cannot replace liver biopsy as the optimal diagnostic procedure for the prediction of hepatic steatosis and fibrosis.