title: Doppler Ultrasound in Liver Cirrhosis: Correlation of Hepatic Artery and Portal Vein Measurements With Model for End-Stage Liver Disease Score.
abstract: OBJECTIVE
  To determine whether hepatic arterial and portal venous Doppler ultrasound measurements of the liver in cirrhotic patients correlate with patients' Model for End-Stage Liver Disease (MELD) scores, splenomegaly, or ascites.
  
  
  METHODS
  Sonographic images and reports were reviewed of 264 patients with hepatic cirrhosis who underwent abdominal ultrasound with Doppler in this internal review board-approved retrospective study. MELD scores were recorded at the time of ultrasound. On gray-scale ultrasound, spleen length was measured and the presence of ascites was noted. Hepatic arterial velocity (HAv) with angle correction, hepatic arterial resistive index, and portal vein velocity with angle correction were measured on Doppler ultrasound. Correlation of hepatic arterial and portal venous Doppler values with MELD score, presence of splenomegaly, and presence of ascites was tested using linear or binary logistic regression analysis. Diagnostic performance of Doppler parameters for high-risk MELD was assessed.
  
  
  RESULTS
  The HAv statistically significantly correlated with the MELD score (P = .0001), spleen size (P =.027), and presence of ascites (P =.0001), whereas the hepatic arterial resistive index and portal vein velocity did not correlate with these factors. For MELD scores greater than 19, an HAv greater than 120 cm/s showed accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 74, 42, 90, 67, and 76%, respectively. With an HAv greater than 160 cm/s, the odds ratio for MELD scores greater than 19 was 42.1.
  
  
  CONCLUSIONS
  We found a statistically significant correlation with elevated HAv and increasing MELD scores, splenomegaly, and presence of ascites in patients with cirrhotic liver disease; this may be a useful imaging biomarker in the evaluation of patients with cirrhosis.
authors.affiliation: Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Hee Sun
authors.initials: HS
authors.lastname: Park
authors.affiliation: Stanford University Medical Center, Stanford, California, USA.
authors.forename: Terry S
authors.initials: TS
authors.lastname: Desser
authors.affiliation: Stanford University Medical Center, Stanford, California, USA.
authors.forename: R Brooke
authors.initials: RB
authors.lastname: Jeffrey
authors.affiliation: Stanford University Medical Center, Stanford, California, USA.
authors.forename: Aya
authors.initials: A
authors.lastname: Kamaya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058625:End Stage Liver Disease / Q000000981:diagnostic imaging*; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
keywords: cirrhosis; gastrointestinal; hepatic arterial buffer response; hepatic artery velocity; model for end-stage liver disease (MELD)