Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

Abstract

Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

Interleaved x‐ray imaging: A method for simultaneous acquisition of quantitative and diagnostic digital subtraction angiography

“…hepatocellular carcinoma and liver cirrhosis) have both been found to increase hepatic arterial velocity. [33][34][35][36] Future work should confirm results in the full range of fluid velocities expected for a clinical scenario.…”

Liver diseases among Arab world, current state and unmet needs, a scoping review

“…Sixty five publications studied the vascular complications of liver cirrhosis, for portal hypertension early detection either by invasive or non-invasive procedures and predictors of bleeding (248)(249)(250), invasive management with trans jugular intrahepatic Porto-systemic shunt (251,252) and rectal ozone (253), management of portal hypertensive gastropathy (254), gastric varices diagnosis and different modalities of management and survival (255)(256)(257)(258)(259), esophageal varices from early noninvasive prediction and diagnosis (260-267), management (268)(269)(270)(271)(272)(273) and risk of rebleeding (274,275), small bowel varices (276), and portal hypertensive colopathy (277). Prediction of risk of portal vein thrombosis (278), diagnosis (201,279,280) and survival (281).…”

Diagnostic Accuracy of Doppler Scan of Portal Vein to Determine Early Cirrhosis of Hepatitis-C Patients in Gujranwala Population

“…In these conditions, Doppler ultrasound can be an important data on the flow statistics of the whole venous framework, the hepatic course and the hepatic veins. 5 Spectral Doppler imaging is essential to quantify the flow velocity and assess the hemodynamics in cirrhosis and portal hypertension. It's crucial to compensate for the angle to 60° or less between the beam and the vessel's long axis 6,7 .…”