title: Value of duplex Doppler ultrasonography in non-invasive assessment of children with chronic liver disease.
abstract: OBJECTIVE
  to investigate the value of duplex Doppler ultrasonography (US) in the assessment of the hemodynamics of the portal and hepatic veins in a cohort of children with chronic liver disease (CLD) and to detect any relationship between the US changes, etiology and severity (or stage) of CLD.
  
  
  METHODS
  we prospectively enrolled 25 children with biopsy-proven CLD. Thirteen had cirrhosis (aged 8.9 ± 2.0 years) and 12 had chronic hepatitis (aged 9.3 ± 2.3 years). Gray scale and color-coded duplex Doppler US were performed for all, as well as 30 healthy age and sex-matched controls. Findings were correlated with clinical, laboratory and histopathological characteristics.
  
  
  RESULTS
  prominent caudate lobe was detected in 100% of cirrhotics, but none of the chronic hepatitis or controls. Thickened lesser omentum and loss of the triphasic waveform of the hepatic vein were present in 69.2% and 53.8% of cirrhotics vs 33.3% and 8.3% of chronic hepatitis respectively. Portal vein flow velocity was significantly lower (P < 0.0001) and the congestion index was significantly higher (P < 0.005) in both patient groups compared to controls. Child-Pugh's staging showed a positive correlation with both abnormal hepatic vein waveform and direction of portal blood flow; and a negative correlation with both hepatic and portal vein flow velocities. No correlation with the etiology of CLD could be detected.
  
  
  CONCLUSIONS
  duplex Doppler added to grayscale US can detect significant morphologic and portal hemodynamic changes that correlate with the severity (stage) of CLD, but not with etiology.
authors.affiliation: Department of Pediatrics, Cairo University, Cairo 11559, Egypt. melshabrawi@medicine.cu.edu.eg
authors.forename: Mortada Hf
authors.initials: MH
authors.lastname: El-Shabrawi
authors.forename: Maissa
authors.initials: M
authors.lastname: El-Raziky
authors.forename: Maha
authors.initials: M
authors.lastname: Sheiba
authors.forename: Hanaa M
authors.initials: HM
authors.lastname: El-Karaksy
authors.forename: Mona
authors.initials: M
authors.lastname: El-Raziky
authors.forename: Fetouh
authors.initials: F
authors.lastname: Hassanin
authors.forename: Abeer
authors.initials: A
authors.lastname: Ramadan
mesh_terms: D002648:Child; D002908:Chronic Disease; D006439:Hemodynamics; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*