Hepatic arterial doppler sonography in patients with cirrhosis and controls: observer and equipment variability with use of the ultrasonic contrast agent SHU 508A.
OBJECTIVE
The aims of this study on hepatic arterial Doppler sonography were to ascertain interobserver and interequipment variability, to investigate any potential artificial influence of the ultrasonic contrast agent on the Doppler measurements and to compare the results in healthy and cirrhotic subjects.


METHODS
Doppler sonography of the left hepatic artery was performed in nine healthy and nine cirrhotic subjects by three independent observers using three different devices. Continuous infusion of the ultrasonic contrast agent SHU 508A and placebo were administered in a double blind fashion. Systolic, mean and end diastolic peak velocities as well as resistive and pulsatility indices were measured.


RESULTS
Equipment associated variances (5.8 - 12.7 %) of the five Doppler parameters were greater than interobserver variances (0.3 - 3.6 %). No significant differences were observed between the velocities using ultrasonic contrast agent and placebo. Systolic (65.9 +/- 3.6 vs. 47.7 +/- 4.2 cm/s mean +/- SE, p = 0.02) and mean peak velocity (35.4 +/- 1.6 vs. 24.5 +/- 1.8 cm/s, p = 0.007) were significantly higher in cirrhotic than in healthy subjects whereas the resistive and pulsatility indices were not different.


CONCLUSIONS
Doppler sonography of the left hepatic artery performed by various observers is reproducible as long as the same device is used. Under clinical conditions, velocities are correctly measured with the use of ultrasonic contrast agent and are elevated in patients with cirrhosis.
Klinik für Innere Medizin I, Martin-Luther-Universität Halle-Wittenberg, Germany. huebner@krankenhaus-koethen.de
G H
GH
Hübner
N
N
Steudel
A
A
Reissmann
I
I
Kühne
G
G
Kleber
K
K
Schärff
W E
WE
Fleig
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000502:physiology; D002138:Calibration; D003287:Contrast Media / Q000008:administration & dosage*; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011134:Polysaccharides; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D012016:Reference Values; D018608:Ultrasonography, Doppler / Q000295:instrumentation* / Q000706:statistics & numerical data; D014655:Vascular Resistance / Q000502:physiology
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508