Back to Search
Start Over
Assessment of intrahepatic blood flow by Doppler ultrasonography: Relationship between the hepatic vein, portal vein, hepatic artery and portal pressure measured intraoperatively in patients with portal hypertension
- Source :
- BMC Gastroenterology, BMC Gastroenterology, Vol 11, Iss 1, p 84 (2011)
- Publisher :
- Springer Nature
-
Abstract
- Background Abnormality of hepatic vein (HV) waveforms evaluated by Doppler ultrasonography has been widely studied in patients with chronic liver disease. We investigated the correlation between changes in HV waveforms and portal vein velocity (PVVel), the hepatic artery pulsatility index (HAPI), and also the extent of abnormal Doppler HV waveforms expressed as damping index (DI), severity of portal hypertension expressed as Child-Pugh scores and portal pressure (PP) measured directly from patients with portal hypertension (PHT) to evaluate the indicative value of abnormal HV waveforms and discuss the cause of abnormal HV waveform. Methods Sixty patients who had been diagnosed with PHT and accepted surgical therapy of portosystemic shunts were investigated. PP was measured intraoperatively. Thirty healthy volunteers with no history of chronic liver disease were enrolled as the control group. HV waveforms were categorized as triphasic, biphasic or monophasic. DI was compared as the quantitative indicator of abnormal HV waveforms. Another two Doppler parameters, PVVel and HAPI were also measured. These Doppler features were compared with PP, Child-Pugh scores and histological changes assessed by liver biopsy. Results In the patient group, the Doppler flow waveforms in the middle HV were triphasic in 31.6%, biphasic in 46.7%, and monophasic in 21.6% of subjects. These figures were 86.7%, 10.0%, and 3.3%, respectively, in healthy subjects. With the flattening of HV waveforms, the HAPI increased significantly (r = 00.438, p < 0.0001), whereas PVVel decreased significantly (r = -0.44, p < 0.0001). Blood flow parameters, HAPI, PVVel and HV-waveform changes showed no significant correlations with Child-Pugh scores. The latter showed a significant correlation with PP (r = 0.589, p = 0.044). Changes of HV waveform and DI significantly correlated with PP (r = 0.579, r = 0.473, p < 0.0001), and significant correlation between DI and Child-Pugh scores was observed (r = 0.411, p = 0.001). PP was significantly different with respect to nodule size (p < 0.05), but HV-waveform changes were not significantly correlated with pathological changes. Conclusion In patients with PHT, a monophasic HV waveform indicates higher portal pressure. Furthermore, quantitative indicator DI can reflect both higher portal pressure and more severe liver dysfunction. Flattening of HV waveforms accompanied by an increase in the HAPI and decrease in PVVel support the hypothesis that histological changes reducing HV compliance be the cause of abnormality of Doppler HV waveforms from the hemodynamic angle.
- Subjects :
- Adult
Male
medicine.medical_specialty
Portal venous pressure
Hemodynamics
Hepatic Veins
Chronic liver disease
Gastroenterology
Young Adult
Hepatic Artery
Internal medicine
Hypertension, Portal
medicine
Humans
lcsh:RC799-869
Vein
medicine.diagnostic_test
business.industry
Portal Vein
Ultrasonography, Doppler
General Medicine
Blood flow
Middle Aged
medicine.disease
Portal Pressure
medicine.anatomical_structure
Liver biopsy
Case-Control Studies
Cardiology
Portal hypertension
lcsh:Diseases of the digestive system. Gastroenterology
Female
business
Blood Flow Velocity
Artery
Research Article
Liver Circulation
Subjects
Details
- Language :
- English
- ISSN :
- 1471230X
- Volume :
- 11
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Gastroenterology
- Accession number :
- edsair.doi.dedup.....3cfe39dcdd3d5f88bfe0463d0351ab52
- Full Text :
- https://doi.org/10.1186/1471-230x-11-84