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.
Vizzutti
Francesco
F
Dipartimento di Medicina Interna, Università degli Studi di Firenze, Viale G.B. Morgagni, Firenze, Italy.
Arena
Umberto
U
Rega
Luigi
L
Romanelli
Roberto Giulio
RG
Colagrande
Stefano
S
Cuofano
Stefania
S
Moscarella
Stefania
S
Belli
Giacomo
G
Marra
Fabio
F
Laffi
Giacomo
G
Pinzani
Massimo
M
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