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. 2006 Sep 28;12(36):5853-8.
doi: 10.3748/wjg.v12.i36.5853.

Doppler study of hepatic vein in cirrhotic patients: correlation with liver dysfunction and hepatic hemodynamics

K-C Sudhamshu  1 , Shoiichi Matsutani, Hitoshi Maruyama, Taro Akiike, Hiromitsu Saisho
Affiliations

Doppler study of hepatic vein in cirrhotic patients: correlation with liver dysfunction and hepatic hemodynamics

K-C Sudhamshu et al. World J Gastroenterol. .

Abstract

Aim: To elucidate the significance of Doppler measurements of hepatic vein in cirrhotic patients and to correlate with liver dysfunction and hepatic hemodynamics.

Methods: One hundred patients with liver cirrhosis and 60 non-cirrhotic controls were studied. Doppler waveforms were obtained from right hepatic vein and flow velocity measured during quiet respiration. Doppler measurements were also obtained from portal trunk, right portal vein and proper hepatic artery.

Results: Hepatic vein waveforms were classified into three classical patterns. Flat waveform was uncommon. Mean hepatic vein velocity was significantly higher in cirrhotic patients (12.7 +/- 6.4 vs 5.1 +/- 2.1 and 6.2 +/- 3.2 cm/s; P<0.0001). The poorer the grade of cirrhosis, the higher was the mean velocity. Maximum forward velocity was never greater than 40 cm/s in controls. Degree of ascites was found to be highly correlated with mean velocity. "Very highq group (>=20 cm/s) presented clinically with moderate to massive ascites. Correlations between right portal flow and mean velocity was significant (P<0.0001, r = 0.687).

Conclusion: Doppler waveforms of hepatic vein, which is independent of liver dysfunction, should be obtained during normal respiration. Mean hepatic vein velocity reflects the change in hepatic circulation associated with progression of liver cirrhosis. It can be used as a new parameter in the assessment of liver cirrhosis.

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Figures

Figure 1
Figure 1
Mean hepatic vein velocity in study populations. It was significantly higher in cirrhotic patients than non-cirrhotic controls. (mean ± SD; bP < 0.0001 vs NLP and CH).
Figure 2
Figure 2
Mean hepatic vein velocity in study population. Hepatic vein velocity in cirrhotic patients according to Child-Pugh group (mean ± SD; bP < 0.0001 vs A and B).
Figure 3
Figure 3
Maximum forward velocity of hepatic vein in study populations. (mean ± SD; bP < 0.0001 vs NLP and CH).
Figure 4
Figure 4
Relation between mean hepatic vein velocity and liver function test in cirrhotic patients. A: serum albumin; B: serum bilirubin; C: prothrombin time.
Figure 5
Figure 5
Mean hepatic vein velocity in patients depending upon the accumulation of ascites. (mean ± SD; bP < 0.01 vs nil and moderate to massive).
Figure 6
Figure 6
Correlation between mean hepatic vein velocity and right portal vein flow in cirrhotic patients (A) and controls (B).
Figure 7
Figure 7
Right portal flow in cirrhotic patients. “Very high” group, which we defined as those having velocity ≥ 20 cm/s had increased perfusion of right lobe of the liver.
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