The role of Doppler velocity histograms of hepatic veins in early detection of cirrhotic changes of the liver parenchyma.
OBJECTIVE
In a prospective study we measured the velocity ranges of the Doppler Velocity Histogram (DVH) of the hepatic venous system at two levels (-3 dB and -6 dB) below the maximum power level of the Doppler wave in order to investigate if that allows a higher selectivity between the Doppler tracings in hepatic veins of patients with liver cirrhosis and healthy subjects.


METHODS
The DVH was measured in 23 healthy subjects and 31 patients with liver cirrhosis of different etiologies at power levels of -3 and -6 dB in the right and middle hepatic vein after an overnight fast. The DVH measurements were performed at the maximum of phase I of the hepatic venous flow in which we assessed the Peak-, Mode-, Mean-Value, and the velocity range (bandwidth).


RESULTS
At both power levels the bandwidth (BW) of the DVH in the right and middle hepatic vein was significantly higher in cirrhotics than in healthy subjects (-3 dB: RHV: p = 0.048, MHV: p = 0.006; -6 dB: RHV and MHV: p < 0.0005). The selectivity between healthy subjects and cirrhotics is higher at the -6 dB level than at the -3 dB level.


CONCLUSIONS
The DVH-measurement is a useful additional device in early sonographic detection of cirrhotic liver parenchyma changes. DVH-velocity range measurements at a level of -6 dB below the maximum power level reveal a better selectivity between healthy subjects and cirrhotic patients than measurements at the -3 dB level. It is recommendable to perform velocity range measurements at different power levels within a single frozen image.
Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover.
M
M
Dömland
M
M
Gebel
U K
UK
Teichgräber
M P
MP
Manns
D000328:Adult; D000368:Aged; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D012016:Reference Values; D014463:Ultrasonography