Background
: Chronic liver dysfunction, especially fatty liver and chronic hepatitis, is a common problem in primary care. In such case, physicians diagnosed the liver disease through the history and physical examination, blood chemistry, hepatitis viral markers, and radiologic study. We carried out this study to determine the clinical association between noninvasive diagnostic methods and liver biopsy.

Methods : Age and sex distribution, blood chemistry, hepatitis viral markers, sonographic finding and pathologic diagnosis were evaluated in 93 patients with chronically abnormal liver function test who were admitted for liver biopsy to Guro Hospital Korea University form July 1990 to June 1991.

Results : The AST level, 140.7 U/L and ALT level, 227.6 U/L in chronic hepatitis group were more elevated with statistical significance than 90.8 U/L, 98.1 U/L in fatty liver group(p<0.05). But the AST/ALT ratio, 1.14 in fatty liver group was more elevated with statistical significance than 0.74 in chronic hepatitis group(p<0.01). At pathologic diagnosis compared with sonographic finding, diagnosis accuracy of fatty liver was 52.5% and chronic hepatitis was 42.4%. Normal finding on sonography in fatty liver group or chronic hepatitis group by pathologic diagnosis were 44.0%.

Conclusion : The blood chemistry including AST, ALT, AST/ALT ratio, γ-GTP and hepatitis viral markers, sonography all are available diagnostic method in the chronic liver dysfunction. But we should be considering that liver biopsy was needed for more accurate diagnosis of liver disease.