Doppler assessment of splanchnic arterial flow in patients with liver cirrhosis: correlation with ammonia plasma levels and MELD score.
OBJECTIVE
To assess the clinical significance of blood flow velocity and resistance index (RI) in the visceral arteries of patients with liver cirrhosis with respect to plasma ammonia (NH3) level and liver function.


METHODS
We included 80 patients with liver cirrhosis (58 men) and 20 healthy controls (11 men). Duplex Doppler ultrasonography was used to assess flow velocity and RI in the hepatic (HA), right (RRA), and left renal (LRA), and splenic (SA) (LA) artery. Plasma NH3 was measured by biochemistry. Liver function was assessed by MELD score (model of end-stage liver disease).


RESULTS
HA, LRA, and SA systolic flow velocities were greater, whereas RRA diastolic velocity was lower in patients with liver cirrhosis than in controls RI was higher in LRA, RRA, SA, and HA in patients with liver cirrhosis than in controls. NH3 levels were significantly elevated in all patients with liver cirrhosis (p < 0.05) and significantly correlated with RI of RRA, LRA, and SA.


CONCLUSIONS
We found greater renal, hepatic, and LA RI in patients with liver cirrhosis than in healthy controls. The correlation we found between elevated renal artery RI (≥0.70) and MELD score emphasizes the risk of renal dysfunction during progression of liver cirrhosis.
Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Serbia.
Tijana M
TM
Glišić
Mirjana D
MD
Perišić
Sladjana
S
Dimitrijevic
Vladimir
V
Jurišić
D000328:Adult; D000368:Aged; D000641:Ammonia / Q000378:metabolism*; D001783:Blood Flow Velocity / Q000502:physiology; D058625:End Stage Liver Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging*; D008111:Liver Function Tests / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012720:Severity of Illness Index; D013152:Splanchnic Circulation / Q000502:physiology; D013157:Splenic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology
D000641:Ammonia
MELD score; ammonia level; duplex Doppler ultrasonography; liver cirrhosis