Tehran University Medical Journal

Background: Cirrhosis and portal hypertension influence the hepatic circulation. The purpose of this study was to evaluate the diagnostic accuracy of liver Doppler ultrasonography parameters in cirrhosis.

Methods: This case-control study involved 118 subjects. All case subjects had biopsy-proven hepatic cirrhosis. The controls were healthy people, case-matched for age and gender. All cases and controls underwent Doppler ultrasonographic evaluation. We compared the area under the ROC curve of each parameter for cases vs. controls using Fisher's exact test, with p <0.5 indicating significance.

Results: The means of the following parameters for case vs. control subjects were: frequency of portal venous flow inversion, portal vein diameter 12.67±2.72 vs. 10.59±1.69, and hepatic arterial resistance index 0.81±0.07 vs. 0.74±0.09. The mean hepatic artery pulsatility index (1.87±0.48 vs. 1.34±0.23), was significantly higher among the case subjects (P=0.001). The maximum flow rate of the portal vein was also significantly lower in the case subjects (16.50±5.59 vs. 36.74±8.74 cm/s, P=0.001). We did not observe significant differences in the means of the hepatic artery maximum flow rate and end-diastolic flow rate. For diagnosing cirrhosis, the application of 24.1 cm/s as the cutoff point for the portal vein maximum flow rate, we obtain an accuracy of 95.45% (91.23%-97.70%, CI=95%), whereas a cutoff point of 1.54 or more for the hepatic artery pulsatility index yields an accuracy of 85.71% (79.48%-90.29%, CI=95%). Utilizing a hepatic arterial resistance index of 0.765 or greater is associated with an accuracy of 71.05% (62.81%-78.11%, CI=95%) in diagnosing cirrhosis.

Conclusions: Doppler ultrasonography and assessment of hepatic artery and portal vein parameters are accurate methods in the diagnosis of cirrhosis.

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Duplex Doppler ultrasonography (US) has newly suggested, being an important diagnostic technique in the non-invasive evaluation of hepatic vasculature and some hepatic parenchymal diseases. New findings suggest that diffuse fatty infiltration of liver can alter normal hepatic vein and artery doppler indices. The following study has been performed to evaluate the effect of fatty infiltration on hepatic artery resistance index and hepatic vein waveform patterns.
Methods: Sixty patients with various degrees of fatty infiltration on liver biopsy and twenty normal subjects without any sign of hepatic fat infiltration in ultrasonography examined using standard colour and spectral doppler sonography. The waveforms of Hepatic Vein were classified into three groups: regular triphasic waveform, biphasic waveform without a reverse flow, and monophasic or flat waveform. The hepatic artery resistance index was calculated as the mean of three different measurements.
Results: The mean BMI in Nonalcoholic fatty liver disease group and normal subjects was 26.9(SD=3.3) and 22.4(SD=1.7) Kg/m², respectively with a range of 22 up to 44 Kg/m². Abnormal Hepatic Vein waveforms (biphasic and monophasic) were found more frequently in doppler sonography (p<0.001) in patients with Nonalcoholic fatty liver disease (12 biphasic and 17 monophasic) compared to normal subjects. Hepatic artery resistance index was significantly lower in Nonalcoholic fatty liver disease patients [0.7(SD=0.1)] compared to normal ones [0.8(SD=0.0)] (p<0.001).
Conclusions: The incidence of abnormal hepatic vein waveforms is significantly higher in patients with fatty infiltration compared to those who had no abnormality in liver ultrasonography and these patients had a significant lower hepatic artery resistance index. supportFields]> ADDIN EN.CITE  ADDIN EN.CITE.DATA l> 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