title: Relationships between splenorenal shunt/portal vein diameter ratio and systemic hemodynamics in patients with liver cirrhosis.
abstract: OBJECTIVE
  The purpose of this study was to investigate the relationships between the splenorenal shunt (SRS)/portal vein (PV) diameter ratio (SRS/PV ratio) and systemic hemodynamics in patients with liver cirrhosis.
  
  
  METHODS
  Thirty-seven patients with SRS due to liver cirrhosis were included in this study. SRS was evaluated in the retropancreatic space on contrast-enhanced CT and the diameter was measured at the maximum point. Systemic hemodynamics was studied using a thermodilution catheter.
  
  
  RESULTS
  The SRS/PV ratio showed a significant correlation with the cardiac index (p < 0.01), and showed an inverse correlation with the systemic vascular resistance index and the arteriovenous oxygen content difference [C(a-v)O2] (p < 0.01). The Child-Pugh score showed a correlation with the SRS/PV ratio (p < 0.01). The SRS/PV ratio was 0.89 ± 0.52, 1.02 ± 0.51, and 1.74 ± 0.50 in the Child-Pugh A, B, and C classes, respectively. The SRS/PV ratio in the Child-Pugh C class was significantly higher than those in classes A and B (p < 0.01). The plasma ammonia level was 75.3 ± 23.2 in the group with an SRS/PV ratio <1.0 (n = 19) versus 102.6 ± 34.8 in the group with an SRS/PV ratio ≥1.0 (n = 18), and the ratio of encephalopathy was 5% (1/19) in the group with an SRS/PV ratio <1.0 (n = 19) versus 50% (9/18) in the group with an SRS/PV ratio ≥1.0 (n = 18), respectively. The differences between the two groups were statistically significant (p < 0.01).
  
  
  CONCLUSIONS
  We conclude that the increase in the SRS/PV ratio is accompanied by deteriorated liver function, hyperdynamic status, and narrowed C(a-v)O2.
authors: Department of Surgery, Kuniyoshi Hospital, Kuniyoshi Hospital, Kochi, Japan.
authors: Fumio
authors: F
authors: Chikamori
authors: Hiroshi
authors: H
authors: Okamoto
authors: Nobutoshi
authors: N
authors: Kuniyoshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000641:Ammonia / Q000097:blood; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010100:Oxygen / Q000097:blood; D010976:Platelet Count; D017082:Portal Pressure; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D012720:Severity of Illness Index; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014655:Vascular Resistance
chemical_list: D000641:Ammonia; D010100:Oxygen