Hepatic artery hemodynamic responsiveness to altered portal blood flow in normal and cirrhotic livers.

Iwao, T; Toyonaga, Atsushi; Shigemori, Hiroyuki; Oho, Kazuhiko; Sakai, Toshiaki; Tayama, Chizuru; Masumoto, Hideo; Sato, Masafumi; Tanikawa, K

doi:10.1148/radiology.200.3.8756933

Cited by 56 publications

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“…The HBI was impaired significantly in patients with PHT (P = .019), with a blunted HAPI and an increased PVVel from fasting to the postprandial period. These results are in accordance with the acute HABR results of Aoki et al 6,15,16 We considered measuring the LVI more suitable for expressing the baseline HABR because the blood flow factor was eliminated, and only the 2 factors sensitive to hepatic resistance were under evaluation. The measured LVI in the patients with PHT was reduced compared with that in the healthy control subjects.…”

Section: Discussionsupporting

confidence: 87%

“…All patients underwent the examination the day before surgery, and control subjects fasted overnight before the examination. All subjects were examined before and after ingestion of a 2100-kJ (500-kcal) mixed liquid meal, as proposed by Iwao et al 6 Hemodynamic changes were measured 30 minutes after ingestion because a previous study determined that the peak change of blood flow occurred at that time. 9 Measurements of each parameter were made during suspended respiration in the same area before and after ingestion.…”

Section: Doppler Ultrasonographymentioning

confidence: 99%

“…3,4 Haag et al 5 used the congestion index (CI) of the portal vein, which is defined as the ratio of crosssectional area to a portal flow velocity exceeding 0.1 cm/s -1 to diagnose PHT. Other methods used to diagnose PHT include the liver vascular index (LVI), 3 the hepatic buffer index (HBI) proposed by Iwao et al, 6 and the portal hypertension index (PHI). 7 Piscaglia et al 7 proposed a PHI cutoff of 1.2 s/m as the parameter with the highest accuracy (≈75%).…”

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confidence: 99%

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Hemodynamic Features of Doppler Ultrasonography in Patients With Portal Hypertension

Zhang

Duan

et al. 2007

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to investigate the relationship between a series of portal hemodynamic parameters obtained with Doppler ultrasonography and portal pressure measured directly from patients with portal hypertension (PHT). Methods. Fifty-seven patients with a clinical diagnosis of PHT who accepted surgical therapy were investigated. The portal pressure was measured directly intraoperatively. Relevant parameters were compared and measured, including the hepatic artery pulsatility index (HAPI), hepatic artery resistive index (HARI), splenic artery resistive index, splenic artery pulsatility index (SpAPI), congestion index (CI) of the portal vein, hepatic buffer index (HBI), liver vascular index (LVI), and PHT index (PHI). Results. Doppler parameters for the postprandial HAPI, SpAPI, CI, LVI, HBI, and PHI were statistically different in patients with PHT and healthy control subjects (P < 0.05). The portal pressure was significantly correlated with the HARI (r = 0.699; P < .001), HAPI (r = 0.582; P < .001), LVI (r = -0.501; P = .003), HBI (r = 0.441; P = .009), and Child-Pugh scores (r = 0.589; P = .044). Conclusions. The HAPI, LVI, and HBI are indicative indices in patients with PHT, suggesting that color Doppler ultrasonography can be used as a noninvasive evaluation method for PHT degree. The changes in the HAPI, LVI, and HBI that accompany the increase in portal pressure can reflect hepatic resistance and hepatic artery buffer capacity accurately. Key words: cirrhosis; Doppler ultrasonography; hemodynamics; portal hypertension. Diagnosis, Tangdu Hospital, Fourth Military Medical University, Xin Si Road, Ba Qiao District, 710038 Xi'an, China. E-mail: duanyy@fmmu.edu.cn Abbreviations CI, congestion index; FPP, free portal pressure; HAPI, hepatic artery pulsatility index; HARI, hepatic artery resistive index; HBI, hepatic buffer index; HVPG, hepatic venous pressure gradient; LVI, liver vascular index; PHI, portal hypertension index; PHT, portal hypertension; PVVel, portal vein velocity; SpAPI, splenic artery pulsatility index; SpARI, splenic artery resistive index ortal hypertension (PHT) is a pathologic increase in hydrostatic pressure in the portal venous system. Ninety percent of patients with PHT have sinusoidal or postsinusoidal PHT. Portal hypertension is mainly caused by liver cirrhosis, such as posthepatitis B or C cirrhosis. Clinically, PHT is suspected in patients with splenomegaly and ascites, and the diagnosis is confirmed when portosystemic collateral channels are present. Measurement of the hepatic venous pressure gradient (HVPG) is one method used to evaluate PHT. The HVPG measures the difference in pressure between a free position and a wedged position in 1 hepatic vein. The second method, free portal pressure (FPP), is used to directly measure portal pressure intraoperatively. Patients with an FPP exceeding 22 mm Hg are considered

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Section: Discussionsupporting

confidence: 87%

Section: Doppler Ultrasonographymentioning

confidence: 99%

mentioning

confidence: 99%

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Hemodynamic Features of Doppler Ultrasonography in Patients With Portal Hypertension

Zhang

Duan

et al. 2007

Journal of Ultrasound in Medicine

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“…Progressivamente, dificuldades relacionadas ao método foram sendo reconhecidas e equacionadas para que esta técnica pudesse ser utilizada eficientemente no estudo deste sistema vascular (3,7,20,22,27,28) . Sua importância no estudo da síndrome hipertensiva portal ficou estabelecida quando, apesar das dificuldades inerentes ao método, foi avaliado o prognóstico de pacientes com cirrose hepática (2,8,9,10,11,12,13,17,18,25,26,29,30) . Tais estudos, entretanto, foram realizados predominantemente em pacientes portadores de cirrose hepática, mas suas contribuições podem ser estendidas à investigação fisiopatológica do sistema portal na fibrose hepática esquistossomótica.…”

Section: Comentáriosunclassified

Hipertensão portal por esquistossomose mansônica hepatoesplênica: efeito da desconexão ázigo-portal com esplenectomia no diâmetro e na velocidade média de fluxo do sistema portal (estudo ultra-sonográfico com Doppler)

Widman

Oliveira

Speranzini

et al. 2001

Arq. Gastroenterol.

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“…Portal blood flow peaks around 30-60 minutes after meal ingestion [27], suggesting we, indeed, scanned around peak flow.…”

Section: Comparison To the Literaturementioning

confidence: 96%

Arterial and portal venous liver perfusion using selective spin labelling MRI

et al. 2015

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Purpose To investigate the feasibility of selective arterial and portal venous liver perfusion imaging with spin labelling (SL) MRI, allowing separate labelling of each blood supply. Methods The portal venous perfusion was assessed with a pulsed EPISTAR technique and the arterial perfusion with a pseudo-continuous sequence. To explore precision and reproducibility, portal venous and arterial perfusion were separately quantified in 12 healthy volunteers pre-and postprandially (before and after meal intake). In a subgroup of 6 volunteers, the accuracy of the absolute portal perfusion and its relative postprandial change were compared with MRI flow measurements of the portal vein. Results The portal venous perfusion significantly increased from 63±22 ml/100g/min preprandially to 132±42 ml/100g/ min postprandially. The arterial perfusion was lower with 35± 22 preprandially and 22±30 ml/100g/min postprandially. The pre-and postprandial portal perfusion using SL correlated well with flow-based perfusion (r 2 =0.71). Moreover, postprandial perfusion change correlated well between SL-and

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Hepatic artery hemodynamic responsiveness to altered portal blood flow in normal and cirrhotic livers.

Abstract: Hepatic artery vascular responsiveness to altered portal blood flow is blunted in cirrhotic livers.

Cited by 56 publications

References 0 publications

Hemodynamic Features of Doppler Ultrasonography in Patients With Portal Hypertension

Hemodynamic Features of Doppler Ultrasonography in Patients With Portal Hypertension

Hipertensão portal por esquistossomose mansônica hepatoesplênica: efeito da desconexão ázigo-portal com esplenectomia no diâmetro e na velocidade média de fluxo do sistema portal (estudo ultra-sonográfico com Doppler)

Arterial and portal venous liver perfusion using selective spin labelling MRI

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