Purpose Blood flow dynamics represent a diagnostic criterion for many
diseases. However, no established reference standard is available. In clinical
practice, ultrasound pulsed-wave Doppler (PW-Doppler) is frequently used to
assess visceral blood flow, despite its well-known limitations. A quantitative
analysis of conventional color Doppler patterns can be performed using an
innovative ultrasound-based algorithm (pixel flow analysis, PFA). This tool
already shows promising results in obstetrics, but the technique has not yet
been evaluated for portal venous blood flow assessment.
Methods This prospective exploratory research study evaluated the
applicability of PFA in the portal venous system. Measurements of portal venous
flow using PFA and PW-Doppler were compared in healthy volunteers (n=20)
and in patients with hepatic steatosis (n=10) and liver cirrhosis
(n=10).
Results In healthy volunteers (60% female, mean age 23 years, BMI
21.5 kg/m2 [20.4–23.8]), PFA and
PW-Doppler showed a strong positive correlation in fasting conditions
(r=0.69; 95% CI 0.36–0.87), recording a median blood
flow of 834 ml/min (624–1066) and
718 ml/min (620–811), respectively. PFA was also
applicable in patients with chronic liver diseases (55% female, age 65
years (55–72); BMI 27.8 kg/m2
(25.4–30.8)), but the correlation between PFA and PW-Doppler was poor
(r=− 0.09) in the subgroup with steatosis. A better
correlation (r=0.61) was observed in patients with liver cirrhosis.
Conclusion PFA and PW-Doppler assessment of portal venous vascularization
showed high agreement in healthy volunteers and patients with liver cirrhosis.
Therefore, PFA represents a possible alternative to conventional PW-Doppler
sonography for visceral blood flow diagnostics and merits further
evaluation.