The value of Doppler US in the study of hepatic hemodynamics

Barbara, L; Okuda, Kunihiko; Taylor, Kenneth J. W.; Groszmann, R. J.; Bolondi, Luigi; Burns, P N; Gaiani, Stefano; Bosch, J. Pericas; Braillon, Alain; Dauzat, M.; Lafortune, M; Lebrec, Didier; Moriyasu, F; Pagliaro, Luigi; Pisi, E; Pomier‐Layrargues, Gilles; Sieber, Cornel C.; Verme, G; Wells, Peter B.; Williams, R.

doi:10.1016/0168-8278(90)90146-i

Cited by 61 publications

(13 citation statements)

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“…Many physiologic stimuli, such as posture, meal, and physical exercise, may also significantly influence blood flow velocity in this vessel (14,15,18). Prerequisites for accurate and reproducible measurements of flow velocity are, therefore, a beam/vessel angle less than 60°, average values taken in fasting supine patients over several cardiac cycles, repeated (at least three) average velocity measurements, and good visualization with a straight course of the vessel for at least 3 cm (21). These conditions can be satisfactorily achieved in 6046% of subjects submitted to Doppler US examination (26).…”

Section: Discussionmentioning

confidence: 98%

“…In all patients the following variables were studied: a ) the mean velocity of portal venous flow (V,,,,) (in cm/sec), which is related to the splanchnic venous out-HOW; b) the resistance index (RI) of the SMA, calculated as follows: R1 = (S-D)/S, as described by Planilo et al (19), where S = peak systolic velocity, and D = end peak diastolic velocity. This semi-quantitative factor, based on the relationship between systolic and diastolic flow velocities, is related to the impedance of the arterial bed (19,20), which includes the resistance, compliance, and congestion of the vascular bed (21).…”

Section: Study Protocolmentioning

confidence: 99%

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Changes in Splanchnic Hemodynamics in Inflammatory Bowel Disease Non-Invasive Assessment by Doppler Ultrasound Flowmetry

Bolondi

Gaiani

Brignola

et al. 1992

Scandinavian Journal of Gastroenterology

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An increase in splanchnic blood flow in both arterial and venous beds has been demonstrated in inflammatory bowel disease (IBD) by means of angiographic and scintigraphic studies. Doppler ultrasound (US) enables a non-invasive evaluation of splanchnic arterial inflow in the superior mesenteric artery (SMA) and of venous outflow in the portal vein. The aim of this study was to assess the role of Doppler US in detecting changes in the hemodynamic variables measured in patients with IBD. Forty-five patients with IBD were studied, including 22 with Crohn's disease (CD) and 23 with ulcerative colitis (UC), and compared with 45 matched normal subjects. The mean velocity of portal flow (Vmean) and the resistance index (RI) of the SMA were evaluated by Doppler US. In CD the Vmean of portal flow was significantly higher in patients with active disease than in controls (p less than 0.001) and patients with inactive disease (p less than 0.001). The RI of the SMA was significantly lower in active disease than in controls (p less than 0.005), but no significant difference was noted between active and inactive CD. Also in UC, the Vmean of portal flow was significantly higher in patients with active disease than in controls (p less than 0.01) and patients with inactive disease (p less than 0.05). The RI of the SMA was significantly lower in active disease than in controls (p less than 0.005) and in patients with inactive disease (p less than 0.005). Doppler follow-up studies were carried out in 10 patients after initiation of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 98%

Section: Study Protocolmentioning

confidence: 99%

Changes in Splanchnic Hemodynamics in Inflammatory Bowel Disease Non-Invasive Assessment by Doppler Ultrasound Flowmetry

Bolondi

Gaiani

Brignola

et al. 1992

Scandinavian Journal of Gastroenterology

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“…Because of the difficulties in standardizing the quantitative measurement of velocity, diameter, and flow in the hepatic veins and inferior vena cava, only qualitative judgments of direction and configuration of the velocity profile were attempted in these vessels. [5][6][7] Abnormalities of hepatic veins can occur in different diseases (eg, marked hepatomegaly, severe fatty infiltration, Budd-Chiari syndrome, cardiac failure, constrictive pericarditis, portal hypertension, tricuspid regurgitation). In these diseases Doppler waveform may be changed by the underlying pathology.…”

Section: Discussionmentioning

confidence: 99%

Hepatic vein Doppler waveform changes in early stage (Child-Pugh A) chronic parenchymal liver disease

Arda

Ofelli

Çalikoğlu

et al. 1997

J. Clin. Ultrasound

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“…18 However, a caution is indicated when interpreting small changes in the measurement of the Doppler ultrasound indices i.e. even in normal conditions substantial variability exists in hepatic arterial measures.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Artery Doppler Indices in Children with Extra Hepatic Portal Vein Obstruction

Jesudoss¹,

Chandrasekaran²,

Sathiyasekaran³

et al. 2013

Journal of Clinical and Experimental Hepatology

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Doppler measurement provides information on the hemodynamics in the hepatic artery and the portal venous system. Aim: To study the hepatic artery hemodynamics in children with extra hepatic portal vein obstruction. Materials and methods: Hepatic artery indices were studied using Doppler indices in 15 children (<12 years) with extra hepatic portal hypertension (EHPVO) and obliterated esophageal varices. The hepatic artery resistive index, the arterial acceleration time and the acceleration index were used to determine the flow pattern within the hepatic artery. Controls were 15 healthy age-sex matched children, belonging to the same socioeconomic strata in absence of liver disease. Results: The mean age of the children was 8.43 ± 3.2 years and male female ratio was 4:1. All the children had obliterated esophageal varices. The hepatic artery resistive index in the children with EHPVO was normal and similar to controls. The hepatic arterial early systolic acceleration index was significantly higher in cases compared to controls (436 ± 290 vs 214 ± 100; P value <0.004). The hepatic arterial acceleration time though low in the cases (86 ± 35 cm/s) was not statistically different from the controls (128 ± 14 cm/s). Conclusion: There was a significant increase in hepatic arterial early systolic acceleration in children with chronic EHPVO. The latter may be responsible for an increase in hepatic arterial in flow velocity in a slow flow system despite a normal resistive index. Congestive index and venous pulsatility index in the portal vein, both in adult and pediatric patients are determinants of the hemodynamic status of the portal system. 8,9These indices are not reliable in portal vein thrombosis and portal cavernoma as there is a poor correlation between the size of the portal vein and portal pressure. 7,10 Also, the transformation of the portal vein to a cavernoma makes measurement of these indices difficult.Hepatic artery indices are likely to be more informative 11 under such circumstances. One can get a clue to the hemodynamics of the blood flow in the hepatic artery. Till date, there are no published studies that have reported on hemodynamics in hepatic artery in patients with cavernomatous transformation of the portal vein.McNaughton et al 12 describes the normal hepatic arterial waveform in the hepatic artery to be pulsatile with low resistance. The peak height of the wave corresponds to the peak systolic velocity (V 1 ), and the trough to enddiastolic velocity (V 2 ) The normal resistive index (RI) within the hepatic artery ranges from 0.55 to 0.8. Any measured RI above or below the normal range represents a disease state. 13-15The aim of the present study was to determine the hepatic artery resistive index, the acceleration time and the acceleration index in children with EHPVO. MATERIALS AND METHODSThe Liver Unit at Stanley Hospital predominantly caters to the adult population. The present study included 15 children with EHPVO who were referred to the Liver Clinic for management of variceal bleed. All these...

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The value of Doppler US in the study of hepatic hemodynamics

Cited by 61 publications

References 0 publications

Changes in Splanchnic Hemodynamics in Inflammatory Bowel Disease Non-Invasive Assessment by Doppler Ultrasound Flowmetry

Changes in Splanchnic Hemodynamics in Inflammatory Bowel Disease Non-Invasive Assessment by Doppler Ultrasound Flowmetry

Hepatic vein Doppler waveform changes in early stage (Child-Pugh A) chronic parenchymal liver disease

Hepatic Artery Doppler Indices in Children with Extra Hepatic Portal Vein Obstruction

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