title: A Doppler waveform index to characterize hepatic vein velocity pattern and evaluate hepatic fibrosis.
abstract: OBJECTIVE
  To describe a Doppler waveform index representing the hepatic vein flow velocity pattern and to examine its relationship to the degree of hepatic fibrosis.
  
  
  METHODS
  Doppler waveforms were obtained in 66 patients scheduled for percutaneous liver needle biopsy and categorized as normal (with a retrograde flow phase) or abnormal (without retrograde flow). Waveforms were also characterized using a hepatic vein waveform index (HVWI): (maximum - minimum velocity)/(maximum velocity). Biopsy specimens were graded for fibrosis.
  
  
  RESULTS
  There was a highly significant decrease in HVWI with increasing fibrosis score in the biopsy (p < 0.001, Jonckheere trend test). The biopsy showed cirrhosis in 14 of 29 patients (48%) with absent retrograde flow and 5 of 37 patients (14%) with a normal flow pattern. Using HVWI as the criterion, cirrhosis was present in 13 of 21 (62%) patients with HVWI < 0.75, in 6 of 31 (19%) patients with 0.75 < HVWI < 1.50, and in none of 14 (0%) patients with HVWI > 1.50.
  
  
  CONCLUSIONS
  HVWI is inversely correlated to the degree of liver fibrosis and may be more efficient than the presence or absence of retrograde flow in diagnosing and grading hepatic fibrosis.
authors.affiliation: Department of Radiology, Glostrup Hospital, University of Copenhagen, DK-2600 Glostrup, Denmark.
authors.forename: Jan Fog
authors.initials: JF
authors.lastname: Pedersen
authors.forename: Lone Galmstrup
authors.initials: LG
authors.lastname: Madsen
authors.forename: Vibeke Andrée
authors.initials: VA
authors.lastname: Larsen
authors.forename: Ole
authors.initials: O
authors.lastname: Hamberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Horn
authors.forename: Birgitte
authors.initials: B
authors.lastname: Federspiel
authors.forename: Peter
authors.initials: P
authors.lastname: Bytzer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001783:Blood Flow Velocity; D005260:Female; D006503:Hepatic Veins; D006801:Humans; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler