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. 2010 Dec 28;16(48):6139-44.
doi: 10.3748/wjg.v16.i48.6139.

Value of duplex Doppler ultrasonography in non-invasive assessment of children with chronic liver disease

Mortada Hf El-Shabrawi  1 , Maissa El-Raziky, Maha Sheiba, Hanaa M El-Karaksy, Mona El-Raziky, Fetouh Hassanin, Abeer Ramadan
Affiliations

Value of duplex Doppler ultrasonography in non-invasive assessment of children with chronic liver disease

Mortada Hf El-Shabrawi et al. World J Gastroenterol. .

Abstract

Aim: to investigate the value of duplex Doppler ultrasonography (US) in the assessment of the hemodynamics of the portal and hepatic veins in a cohort of children with chronic liver disease (CLD) and to detect any relationship between the US changes, etiology and severity (or stage) of CLD.

Methods: we prospectively enrolled 25 children with biopsy-proven CLD. Thirteen had cirrhosis (aged 8.9 ± 2.0 years) and 12 had chronic hepatitis (aged 9.3 ± 2.3 years). Gray scale and color-coded duplex Doppler US were performed for all, as well as 30 healthy age and sex-matched controls. Findings were correlated with clinical, laboratory and histopathological characteristics.

Results: prominent caudate lobe was detected in 100% of cirrhotics, but none of the chronic hepatitis or controls. Thickened lesser omentum and loss of the triphasic waveform of the hepatic vein were present in 69.2% and 53.8% of cirrhotics vs 33.3% and 8.3% of chronic hepatitis respectively. Portal vein flow velocity was significantly lower (P < 0.0001) and the congestion index was significantly higher (P < 0.005) in both patient groups compared to controls. Child-Pugh's staging showed a positive correlation with both abnormal hepatic vein waveform and direction of portal blood flow; and a negative correlation with both hepatic and portal vein flow velocities. No correlation with the etiology of CLD could be detected.

Conclusion: duplex Doppler added to grayscale US can detect significant morphologic and portal hemodynamic changes that correlate with the severity (stage) of CLD, but not with etiology.

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Figures

Figure 1
Figure 1
Triphasic waveform pattern of normal hepatic vein.
Figure 2
Figure 2
Abnormal waveform pattern of hepatic veins in a cirrhotic liver.
Figure 3
Figure 3
Correlation between portal vein flow velocity and portal vein diameter.
Figure 4
Figure 4
Correlation between Child-Pugh’s classification and portal vein velocity.
See this image and copyright information in PMC

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