Performance of Doppler ultrasound in the prediction of severe portal hypertension in hepatitis C virus-related chronic liver disease.
OBJECTIVE
To evaluate the correlation between hepatic vein pressure gradient measurement and Doppler ultrasonography (DUS) in patients with chronic liver disease (CLD).


METHODS
Sixty-six patients with fibrotic to cirrhotic hepatitis C virus-related CLD, were consecutively included upon referral to our haemodynamic laboratory. Superior mesenteric artery pulsatility index (SMA-PI), right interlobar renal and intraparenchymal splenic artery resistance indices, were determined, followed by hepatic venous pressure gradient (HVPG) measurement.


RESULTS
A correlation was found between HVPG and intraparenchymal splenic artery resistance index (SA-RI) (r=0.50, P<0.0001), SMA-PI (r=-0,48, P<0.0001), right interlobar renal artery resistance index (RRA-RI) (r=0.51, P<0.0001) in the whole patient population. However, dividing patients according to the presence/absence of severe portal hypertension (i.e. HVPG > or =12 mmHg), a correlation between HVPG and intraparenchymal SA-RI (r=0.70, P<0.0001), SMA-PI (r=-0.49, P=0.02), RRA-RI (r=0.66, P=0.0002) was observed only for HVPG values <12 mmHg. HVPG but not DUS correlated with the presence of esophageal varices (P<0.0001).


CONCLUSIONS
Superior mesenteric artery pulsatility index, intraparenchymal splenic and right interlobar renal artery resistance indices do not adequately predict severe portal hypertension.
Dipartimento di Medicina Interna, Università degli Studi di Firenze, Viale G.B. Morgagni, Firenze, Italy.
Francesco
F
Vizzutti
Umberto
U
Arena
Luigi
L
Rega
Roberto Giulio
RG
Romanelli
Stefano
S
Colagrande
Stefania
S
Cuofano
Stefania
S
Moscarella
Giacomo
G
Belli
Fabio
F
Marra
Giacomo
G
Laffi
Massimo
M
Pinzani
D000328:Adult; D000368:Aged; D001706:Biopsy; D001794:Blood Pressure; D018450:Disease Progression; D005260:Female; D006339:Heart Rate; D019698:Hepatitis C, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology*; D007601:Jugular Veins; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler; D014690:Venous Pressure