Value of Doppler Sonography in Assessing the Progression of Chronic Viral Hepatitis and in the Diagnosis and Grading of Cirrhosis

Abstract

Doppler sonography is sensitive to hemodynamic alterations resulting from inflammation and fibrosis, and if sonography is the study of choice to follow the progression of hepatitis, it will not be adequate without Doppler imaging. Doppler sonography has high diagnostic accuracy in cirrhosis despite some false-positive conditions. However, it has a limited role in clinical grading.

Role of Colour Doppler in Evaluation of Hemodynamic Changes in Chronic Hepatitis C Infection

“…Despite the initial increase, portal blood inflow decreases with increasing sinusoidal resistance and development of portosystemic collateral vessels. 5 The degree of liver dysfunction and portal hypertension are influenced by these changes in the hemodynamic of liver. Doppler ultrasound is a non-invasive modality by which the flow velocity and portal venous pressure as well as other parameters could be assessed.…”

The prediction of liver disease status using Doppler observations of the hepatic and portal venous system compared with liver biopsy in patients with chronic hepatitis C

“…12,36,38 A monophasic flow pattern is not related to fibrosis or cirrhosis but to extensive fatty infiltration of the liver. 12,36,[39][40][41] However, while portal and hepatic US Doppler parameters in patients with hepatic disease show differences when compared to controls, the relationship between these parameters and impairment of liver function has not been fully investigated. Despite general agreement that portal vein velocity is decreased in cirrhotic patients, the absolute values of portal flow velocity in both healthy subjects and patients with hepatic disease vary considerably and there is substantial overlap.…”

“…Despite general agreement that portal vein velocity is decreased in cirrhotic patients, the absolute values of portal flow velocity in both healthy subjects and patients with hepatic disease vary considerably and there is substantial overlap. 37 Further, portal vein velocity and portal vein flow have shown correlation with fibrosis stage in larger patient samples, 36 but the accuracy of measurement in single patients is not sufficient for exact fibrosis staging. 11,35 In the current study, the authors noted that there was a strong correlation between hepatic necroinflammatory changes with alterations in the hepatic vein flow pattern as well as portal vein undulations, with sensitivity of 82% (95% CI 65.1%-91.7%) and 75.6% (95% CI 59.4%-87.1%), specificity of 95% (95% CI 87%-98.4%) A very simple mathematical combination of sonographic and Doppler-derived measures to formulate a composite score to predict the known liver disease status of a patient with hepatitis C was statistically and clinically justified.…”

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

“…18 The hepatic artery impedance indices were increased in 14% of cases, which showed that these factors were indicators of chronic viral liver disease, as confirmed by Haktanir and others. 34 Piscaglia and others investigated the influence of hepatic fibrosis on the hepatic artery resistance index in patients with chronic viral hepatitis. 11 They observed that an increase in this index is affected by the degree of fibrosis, and reported a significant difference between patients with chronic liver pathologies and cirrhosis, and healthy persons.…”