Ultrasonography in the diagnosis of portal hypertension: diminished response of portal vessels to respiration.

Bolondi, Luigi; Gandolfi, Letizia; Arienti, Vincenzo; Caletti, G.; Corcioni, E.; Gasbarrini, G.; Labò, G

doi:10.1148/radiology.142.1.7053528

Cited by 214 publications

(93 citation statements)

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“…The portal vein was measured as its internal anterioposterior diameter at the liver hilus during suspended inspiration but avoiding Valsalva's manoeuvre (Bolondi et al 1982). Portal vein diameter was then adjusted to the body height of the individual, thereby correcting the influence of individual biometric variations (Richter et al 1992b).…”

Section: Study Area and Study Designmentioning

confidence: 99%

Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosoma mansoni

Richter

Dacal²,

Siqueira

et al. 1998

Tropical Med Int Health

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SummarySeveral studies have shown that the characteristic hepatic abnormalities induced by Schistosoma mansoni detectable by ultrasound correlate with the degree of oesophageal varices. So far the value of ultrasound for predicting variceal haemorrhage has not been assessed. Fifty Brazilian patients with schistosomal periportal fibrosis from Alagoas State, 18 of whom had already bled from oesophageal varices, were enrolled in a combined cross-sectional and longitudinal study and investigated clinically, by endoscopy and by ultrasound. Twenty-seven of the patients were monitored until another bleeding episode, death or for a minimum of 28 months. Eight of these patients could be followed up for a further three years. A sonographic score, which accounts for the degree of echogenic periportal thickening and of portal vein dilatation, was calculated for all patients. A highly significant correlation (P Ͻ 0.0001) existed between the sonographic score and the occurrence of previous variceal haemorrhage, paralleled by a similar correlation between the sonographic score and the degree of oesophageal varices (P Ͻ 0.001). In the 27 patients monitored longitudinally, the sonographic score indicated the risk of future variceal bleeding (P Ͻ 0.0001). The sonographic score reliably predicts the risk of variceal bleeding in individual patients with periportal fibrosis. Hence, the application of endoscopy, if available at all in endemic areas, may be restricted to the patients at risk of future variceal bleeding, as determined by ultrasound. Since portable devices can be carried even to remote areas, the application of the proposed score in community surveys could provide a new means for the identification of high-risk patients in S. mansoni-infected populations.keywords S. mansoni, hepatic abnormalities, oesophageal varices, ultrasound correspondence Joachim Richter,

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Section: Study Area and Study Designmentioning

confidence: 99%

Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosoma mansoni

Richter

Dacal²,

Siqueira

et al. 1998

Tropical Med Int Health

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“…Two other studies on use of ultrasonography in the diagnosis portal hypertension reported a statistically significant association between portal vein caliber and the onset of portal hypertension. 29,30 The hemodynamic changes assessed did not show any association with sex, age, or disease time. This finding confirms that the population studied was homogenous in terms of demography and clinical progression of HCV infection.…”

Section: Assessment Of Fibrosis In Patients With Hepatitis Cmentioning

confidence: 76%

Non-Invasive Assessment of Fibrosis Using Color Doppler Ultrasound in Patients with Hepatitis C Virus in the Amazon Rainforest, Brazil

Leão

Brock²,

Castilho³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. The purpose of this study was to correlate morphologic and hemodynamic Doppler ultrasound findings as indicators of the degree of inflammation and fibrosis and to diagnose chronic vital hepatitis complications and progression. A prospective, descriptive study of a case series was conducted that analyzed Doppler ultrasound images of the liver and portal system and used the portal vein congestion index, hepatic and splenic artery impedance indices, and the liver vascular index. Of 50 patients positive for antibodies against hepatitis C virus, morphologic changes highlighted increased hepatic parenchyma echogenicity in 24%, and increased gall blander echogenicity and wall thickness in 4%. The most common hemodynamic changes observed were reduced flow velocity in the portal vein trunk in 26%, congestion index changes in 12%, liver vascular index changes in 16%, and splenic and hepatic artery impedance index changes in 14%. These indices were shown to be associated with alanine aminotransferase levels, which suggested that they are important liver damage indicators in the early phase of infection with hepatitis C virus.

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“…However, the use of biopsy in clinical practice has some limitations related to sample errors with an estimated false negative percentage of 24% morbidity and mortality in series of blind biopsies [6] and complications [7] . The non-invasive assessment of chronic liver disease has been attempted by various research groups using either clinical signs [8,9] , gray scale [10][11][12][13][14][15] and colour Doppler ultrasound (CDU) signs and indexes [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , or biochemical parameters in the blood [9] . The use of CDU in diagnosis and staging of chronic viral liver disease has been based on the hypothesis that alteration in liver haemodynamics due to chronic inflammatory changes may indirectly reflect histological alterations.…”

mentioning

confidence: 99%

Ultrasonography in differentiation between chronic viral hepatitis and compensated early stage cirrhosis

Iliopoulos

Vlychou²,

Karatza³

et al. 2008

WJG

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minate CVH from CIR. The alternative Doppler indexes can accurately differentiate chronic virus hepatitis from cirrhosis. These indexes can be used in monitoring chronic virus hepatitis and avoiding unnecessary biopsies. INTRODUCTIONChronic viral hepatitis, mainly caused by hepatitis virus B or C, results in liver parenchyma damage and inflammation and may lead to fibrosis, cirrhosis and/or hepatocellular carcinoma [1][2][3] . Cirrhosis often occurs as an indolent disease and a lot of patients remain asymptomatic [4,5] until the occurrence of decompensation, and are characterised by portal hypertension, variceal bleeding, ascites and hepatic encephalopathy.Liver biopsy is the gold standard for diagnosis and determination of the fibrosis and necroinflammatory changes in chronic viral hepatitis and cirrhosis. However, the use of biopsy in clinical practice has some limitations related to sample errors with an estimated false negative percentage of 24% morbidity and mortality in series of blind biopsies [6] and complications [7] . The non-invasive assessment of chronic liver disease has been attempted by various research groups using either clinical signs [8,9] , gray scale [10][11][12][13][14][15] and colour Doppler ultrasound (CDU) signs and indexes [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , or biochemical parameters in the blood [9] . The use of CDU in diagnosis and staging of chronic viral liver disease has been based on the hypothesis that alteration in liver haemodynamics due to chronic inflammatory changes may indirectly reflect histological alterations. Therefore, positive correlation studies have usually referred to the velocity ratio of hepatic RESULTS: ROC analysis showed that PV congestion index, PV D/VTAM and HA/PV VTAM indices had the best sensitivity and specificity in discriminating CVH from CIR.Stepwise discriminant analysis showed that 88.9% of the originally grouped cases could be correctly classified by the three qualitative and four quantitative variables selected as statistically significant predictors. Among the CVH patients who underwent to biopsy, statistically significant changes were found in those at fibrosis stage 5 compared to fibrosis stages 1-4.

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Ultrasonography in the diagnosis of portal hypertension: diminished response of portal vessels to respiration.

Cited by 214 publications

References 0 publications

Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosoma mansoni

Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosoma mansoni

Non-Invasive Assessment of Fibrosis Using Color Doppler Ultrasound in Patients with Hepatitis C Virus in the Amazon Rainforest, Brazil

Ultrasonography in differentiation between chronic viral hepatitis and compensated early stage cirrhosis

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