Value of Doppler ultrasound parameters of portal vein and hepatic artery in the diagnosis of cirrhosis and portal hypertension.
OBJECTIVE
This prospective study was designed to assess the sensitivity and specificity of Doppler ultrasound parameters in the diagnosis of cirrhosis and portal hypertension.


METHODS
Portal and hepatic arterial Doppler ultrasound was performed on 76 patients with cirrhosis and esophageal varices and on 73 age- and sex-matched controls. The parameters evaluated were portal venous velocity and hepatic arterial pulsatility index. The liver vascular index was calculated as the ratio of portal venous velocity to hepatic arterial pulsatility index.


RESULTS
Portal venous velocity was significantly lower (11.0 +/- 2.4 vs 15.9 +/- 2.8 cm/s, p < 0.001) and hepatic arterial pulsatility index was significantly higher (1.28 +/- 0.18 vs 0.95 +/- 0.17,p < 0.001) in patients than in controls. Thus, the liver vascular index was significantly lower in patients than in controls (8.7 +/- 2.1 vs 17.2 +/- 4.3 cm/s, p < 0.001). The sensitivity and specificity of these parameters in the detection of cirrhosis and portal hypertension was then analyzed with the receiver operating characteristic curve. The best cut-off values were considered to be 13 cm/se of portal venous velocity and 1.1 of hepatic arterial pulsatility index, showing a sensitivity and specificity of 83, 85, 84, and 81%, respectively. The best cut-off value of the liver vascular index was 12 cm/s with a sensitivity and specificity of 97 and 93%, respectively.


CONCLUSIONS
The liver vascular index is a high sensitive and specific Doppler ultrasound parameter in the diagnosis of cirrhosis and portal hypertension.
Iwao
T
T
Department of Medicine II, Kurume University School of Medicine, Japan.
Toyonaga
A
A
Oho
K
K
Tayama
C
C
Masumoto
H
H
Sakai
T
T
Sato
M
M
Tanikawa
K
K
D001706:Biopsy; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000000981:diagnostic imaging; D004945:Esophagoscopy; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006509:Hepatitis B; D006526:Hepatitis C; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011673:Pulsatile Flow; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance