Hemodynamic features of Doppler ultrasonography in patients with portal hypertension: intraoperative direct measurement of portal pressure in the portal venous system.
OBJECTIVE
The purpose of this study was to investigate the relationship between a series of portal hemodynamic parameters obtained with Doppler ultrasonography and portal pressure measured directly from patients with portal hypertension (PHT).


METHODS
Fifty-seven patients with a clinical diagnosis of PHT who accepted surgical therapy were investigated. The portal pressure was measured directly intraoperatively. Relevant parameters were compared and measured, including the hepatic artery pulsatility index (HAPI), hepatic artery resistive index (HARI), splenic artery resistive index, splenic artery pulsatility index (SpAPI), congestion index (CI) of the portal vein, hepatic buffer index (HBI), liver vascular index (LVI), and PHT index (PHI).


RESULTS
Doppler parameters for the postprandial HAPI, SpAPI, CI, LVI, HBI, and PHI were statistically different in patients with PHT and healthy control subjects (P<0.05). The portal pressure was significantly correlated with the HARI (r=0.699; P<.001), HAPI (r=0.582; P<.001), LVI (r=-0.501; P=.003), HBI (r=0.441; P=.009), and Child-Pugh scores (r=0.589; P=.044).


CONCLUSIONS
The HAPI, LVI, and HBI are indicative indices in patients with PHT, suggesting that color Doppler ultrasonography can be used as a noninvasive evaluation method for PHT degree. The changes in the HAPI, LVI, and HBI that accompany the increase in portal pressure can reflect hepatic resistance and hepatic artery buffer capacity accurately.
Zhang
Li
L
Department of Ultrasound Diagnosis, Tangdu Hospital, Fourth Military Medical University, Xin Si Road, Ba Qiao District, 710038 Xi'an, China.
Duan
Yun-You
YY
Li
Jin-Mao
JM
Yin
Ji-Kai
JK
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*