Correlation of hepatic vein Doppler waveform and hepatic artery resistance index with the severity of nonalcoholic fatty liver disease

Mohammadinia, Amir Reza; Bakhtavar, Khadijeh; Ebrahimi‐Daryani, Nasser; Habibollahi, Peiman; Keramati, Mohammad Reza; Fereshtehnejad, Seyed Mohammad; Abdollahzade, Sina

doi:10.1002/jcu.20696

Cited by 35 publications

(46 citation statements)

References 42 publications

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“…Hepatomegaly is a prevalent finding in patients with NAFLD and liver size increases as the degree of NAFLD increases [3,10,15]. In our study, similar to the medical literature, we found that liver size was increased with an increase of fatty infiltration with a statistically significant difference.…”

Section: Discussionsupporting

confidence: 88%

“…The main features of the disease, with the exception of alcohol consumption, are fatty infiltration or lipid deposition in the hepatocytes in addition to elevated liver function tests [2][3][4]. Although NAFLD is accepted as a benign disease, it can progress to non-alcholic steatohepatitis, which is the advanced state of the disease, and can be complicated with liver fibrosis, cirrhosis, and even liver failure [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Gray-scale ultrasonography (US) is an initial, easy to use and widely available imaging modality for NAFLD, but gives limited information about the severity of the disease [7,8]. Duplex Doppler US (DDUS) studies on hepatic vein, portal vein and hepatic artery can give more information about parenchymal damage and the severity of the disease due to changes affecting vascular compliance in the liver [3,[9][10][11][12]. But the effect of NAFLD on the hepatic vein waveform pattern (HVWP) and the hepatic artery resistance index (HARI) is not certain.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Nonalcoholic Fatty Liver Disease on the Hepatic Vein and Artery

Aslan¹,

Türeli²

2014

J Med Diagn Meth

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Objective: To evaluate the effect of the different stages of non-alcoholic fatty liver disease on hepatic vein waveform pattern and hepatic artery resistance index.Methods: 32 patients diagnosed with non-alcoholic fatty liver disease and 14 healthy volunteers as a control group were included in the study. In both groups, liver size was measured and the degree of fatty infiltration was graded by gray-scale ultrasonographic examination. Hepatic vein waveform pattern was assessed and hepatic artery resistance index was measured by duplex Doppler ultrasonography examination. The degree of fatty infiltration was compared with hepatic vein waveform pattern and hepatic artery resistance index values in the patient group.Results: Liver echogenicity was grade 1 in 15 patients, grade 2 in 12 patients, and grade 3 in 5 patients. In the control group, liver echogenicity was not increased. Liver size was increased with the degree of fatty infiltration (p<0.001). The presence of biphasic or monophasic hepatic vein waveform pattern in non-alcoholic fatty liver disease patients was statistically significant (p=0.04). However, mean hepatic artery resistance index was not significantly different (p=0.38). Both hepatic vein waveform pattern and hepatic artery resistance index were not related to the degree of fatty infiltration (p=0.99 and p=0.81, respectively). Conclusion:Vascular compliance of the liver can vary with the fatty infiltration of hepatocytes. This effect can be displayed as abnormal hepatic vein waveform pattern rather than alterations in hepatic artery resistance index values by duplex Doppler ultrasonography.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Nonalcoholic Fatty Liver Disease on the Hepatic Vein and Artery

Aslan¹,

Türeli²

2014

J Med Diagn Meth

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“…Although the traditional ultrasound (US) is an excellent diagnostic technique to reveal the presence of diffuse fatty liver disease, it is neither sensitive nor specific to reveal fibrosis, except in advanced stages where signs of cirrhosis are evident. Previous studies have demonstrated that hepatic artery resistive index (HARI) is significantly altered in patients with NAFLD, with significant reduction of this parameter with increasing of severity of diffuse fatty liver disease [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution

Tana

Tana²,

Rossi

et al. 2016

J Ultrasound

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Purpose of the study Conventional ultrasound (US) is reliable to reveal the presence of non-alcoholic fatty liver disease (NAFLD), but it is neither sensitive nor specific to reveal fibrosis clues, except in advanced stages where signs of cirrhosis are evident. NALFD fibrosis score is a noninvasive parameter that predicts well the presence of significant fibrosis, but correlations with US parameters are lacking. The aim of this study was, therefore, to compare resistive index of hepatic artery (HARI) of NAFLD patients with different severity degrees of diffuse fatty liver disease vs HARI of controls, and to compare HARI of NAFLD patients with different NAFLD fibrosis scores vs HARI of controls. Methods This was a spontaneous, no-profit observational study conducted in our US department between December 2013 and July 2014. Patients with NAFLD with different severity of disease and healthy controls were included. Echogenicity and size of liver and spleen, maximum portal vein velocity, RI, peak systolic velocity (PSV), and end diastolic velocity (EDV) of splenic artery, PSV, EDV, and RI of hepatic artery, and NAFLD fibrosis score were acquired and compared between groups.Results HARI was significantly lower in NAFLD patients than controls (p \ 0.0001). A significant difference was also found between the groups of NAFLD severity (p \ 0.0001). There was also a difference between HARI of NAFLD patients with different NAFLD fibrosis scores vs HARI of controls (p \ 0.0001) with a positive correlation between HARI and NAFLD fibrosis score. Conclusion and discussion Conventional Doppler US can be helpful to detect NAFLD patients with the risk of fibrous tissue accumulation. HARI tends to exceed the range of controls for patients with NAFLD fibrosis score greater than 0.675. The detection of HARI greater than 0.9 in NAFLD patients, regardless of the US degree of severity of steatosis, might suggest the execution of biopsy to predict the risk of progression to steatohepatitis and fibrous tissue accumulation. Low values of HARI may be expression of lower risk, which does not necessitate any biopsy.Keywords Hepatic artery resistive index Á Non-alcoholic fatty liver disease Á NAFLD fibrosis score Á Non-alcoholic steatohepatitis Á Ultrasound Á Color Doppler Sommario Scopo dello studio L'ecografia convenzionale è risultata affidabile nel rilevare la presenza di steatosi epatica, tra cui la forma non alcolica (NAFLD), ma non è né sensibile né specifica nel rivelare indizi suggestivi di fibrosi, tranne che in fase avanzata dove sono presenti segni conclamati di cirrosi. Il NALFD fibrosis score è un parametro non invasivo che predice bene la presenza di fibrosi significativa, ma non ci sono dati in letteratura riguardanti una possibile correlazione con i parametri ecografici. Lo scopo di questo studio è stato quindi quello di confrontare HARI dei pazienti con NAFLD a differente grado di severità di steatosi epatica vs l'HARI dei controlli, e di confrontare HARI dei pazienti affetti da NAFLD a differente NAFLD fibrosis score...

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“…Furthermore, measurements are altered by disease processes that affect hepatic blood flow (right sided heart failure, vasoactive medications, post liver transplant). Diffuse fatty infiltration may also interfere with results of hepatic vein waveform and hepatic artery resistance index [14].…”

Section: Ultrasound-based Measures Of Fibrosismentioning

confidence: 99%