Doppler study of hepatic vein in cirrhotic patients: correlation with liver dysfunction and hepatic hemodynamics.
OBJECTIVE
To elucidate the significance of Doppler measurements of hepatic vein in cirrhotic patients and to correlate with liver dysfunction and hepatic hemodynamics.


METHODS
One hundred patients with liver cirrhosis and 60 non-cirrhotic controls were studied. Doppler waveforms were obtained from right hepatic vein and flow velocity measured during quiet respiration. Doppler measurements were also obtained from portal trunk, right portal vein and proper hepatic artery.


RESULTS
Hepatic vein waveforms were classified into three classical patterns. Flat waveform was uncommon. Mean hepatic vein velocity was significantly higher in cirrhotic patients (12.7 +/- 6.4 vs 5.1 +/- 2.1 and 6.2 +/- 3.2 cm/s; P<0.0001). The poorer the grade of cirrhosis, the higher was the mean velocity. Maximum forward velocity was never greater than 40 cm/s in controls. Degree of ascites was found to be highly correlated with mean velocity. "Very highq group (>=20 cm/s) presented clinically with moderate to massive ascites. Correlations between right portal flow and mean velocity was significant (P<0.0001, r = 0.687).


CONCLUSIONS
Doppler waveforms of hepatic vein, which is independent of liver dysfunction, should be obtained during normal respiration. Mean hepatic vein velocity reflects the change in hepatic circulation associated with progression of liver cirrhosis. It can be used as a new parameter in the assessment of liver cirrhosis.
Sudhamshu
K-C
KC
Liver Unit, Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. sudhamshu@hotmail.com
Matsutani
Shoiichi
S
Maruyama
Hitoshi
H
Akiike
Taro
T
Saisho
Hiromitsu
H
D000368:Aged; D001201:Ascites / Q000000981:diagnostic imaging / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008099:Liver / Q000098:blood supply* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D018617:Ultrasonography, Doppler, Pulsed