title: Value of the measurement of portal flow velocity in the differential diagnosis of asymptomatic splenomegaly.
abstract: OBJECTIVE
  This prospective study was carried on 20 patients (10 with liver cirrhosis and 10 with myelo-lymphoproliferative disorders), consecutively admitted to our ward for splenomegaly and thrombocytopenia, with the aim of evaluating the ability of Duplex-Doppler ultrasonography (DDUS) to discriminate between congestive splenomegaly and enlarged spleen caused by haematological disorders.
  
  
  RESULTS
  Comparing the clinical/laboratory and DDUS findings for the two groups, it emerged that maximum-portal flow velocity (PFV) values revealed the most statistically significant differences: 17.31 SD 2.48 vs. 28.27 SD 3.53 (cm/s, P < 0.001). Discriminant analysis showed that max-PFV is the variable which by itself maximizes the separation between the two groups (F = 71.56; P < 0.0001). The patients with congestive splenomegaly exhibited lower max-PFV than the controls (17.31 SD 2.48 vs. 26.29 SD 2.38 cm/s, P < 0.001), unlike those with haematological diseases, whose max-PFV values were greater, albeit not significantly so (28.27 SD 3.53 vs. 26.29 SD 2.38 cm/s, P = 0.161).
  
  
  CONCLUSIONS
  DDUS assessment of portal haemodynamics thus proved useful in the differential diagnosis of splenomegaly in asymptomatic patients since it distinguishes rapidly and non-invasively between congestive and haemotological splenomegaly. A lower-than-normal max-PFV value indicates congestive splenomegaly; a highish value, on the other hand, suggests a splenomegaly of haematological origin.
authors.affiliation: Department of Internal Medicine, University of Modena, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Tincani
authors.forename: G
authors.initials: G
authors.lastname: Cioni
authors.forename: P
authors.initials: P
authors.lastname: D'Alimonte
authors.forename: A
authors.initials: A
authors.lastname: Cristani
authors.forename: F
authors.initials: F
authors.lastname: Turrini
authors.forename: C
authors.initials: C
authors.lastname: Sardini
authors.forename: R
authors.initials: R
authors.lastname: Romagnoli
authors.forename: E
authors.initials: E
authors.lastname: Ventura
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D003937:Diagnosis, Differential; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D013163:Splenomegaly / Q000000981:diagnostic imaging* / Q000209:etiology*; D018616:Ultrasonography, Doppler, Duplex