title: Abnormal splenic artery diameter/hepatic artery diameter ratio in cirrhosis-induced portal hypertension.
abstract: OBJECTIVE
  To determine an optimal cutoff value for abnormal splenic artery diameter/proper hepatic artery diameter (S/P) ratio in cirrhosis-induced portal hypertension.
  
  
  METHODS
  Patients with cirrhosis and portal hypertension (n = 770) and healthy volunteers (n = 31) underwent volumetric computed tomography three-dimensional vascular reconstruction to measure the internal diameters of the splenic artery and proper hepatic artery to calculate the S/P ratio. The cutoff value for abnormal S/P ratio was determined using receiver operating characteristic curve analysis, and the prevalence of abnormal S/P ratio and associations between abnormal S/P ratio and major complications of portal hypertension were studied using logistic regression.
  
  
  RESULTS
  The receiver operating characteristic analysis showed that the cutoff points for abnormal splenic artery internal diameter and S/P ratio were > 5.19 mm and > 1.40, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 74.2%, 45.2%, 97.1%, and 6.6%, respectively. The prevalence of an abnormal S/P ratio in the patients with cirrhosis and portal hypertension was 83.4%. Patients with a higher S/P ratio had a lower risk of developing ascites [odds ratio (OR) = 0.708, 95%CI: 0.508-0.986, P = 0.041] and a higher risk of developing esophageal and gastric varices (OR = 1.483, 95%CI: 1.010-2.175, P = 0.044) and forming collateral circulation (OR = 1.518, 95%CI: 1.033-2.230, P = 0.034). After splenectomy, the portal venous pressure and maximum and mean portal venous flow velocities were reduced, while the flow rate and maximum and minimum flow velocities of the hepatic artery were increased (P < 0.05).
  
  
  CONCLUSIONS
  The prevalence of an abnormal S/P ratio is high in patients with cirrhosis and portal hypertension, and it can be used as an important marker of splanchnic hemodynamic disturbances.
authors.affiliation: Department of Hepatobiliary Surgery and You-An Liver Transplantation Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Dao-Bing
authors.initials: DB
authors.lastname: Zeng
authors.forename: Chuan-Zhou
authors.initials: CZ
authors.lastname: Dai
authors.forename: Shi-Chun
authors.initials: SC
authors.lastname: Lu
authors.forename: Ning
authors.initials: N
authors.lastname: He
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Hong-Jun
authors.initials: HJ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000209:etiology; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D054893:Cone-Beam Computed Tomography; D018450:Disease Progression; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted; D012039:Regional Blood Flow; D012307:Risk Factors; D013156:Splenectomy; D013157:Splenic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Cirrhosis; Complications; Portal hypertension; Proper hepatic artery internal diameter; Splenectomy; Splenic artery internal diameter