Doppler Ultrasound of Hepatic Artery and Portal Vein: Relationship with Clinical Severity of Hepatitis C Virus Liver Cirrhosis

Abstract
Background: Doppler ultrasonography is an essential part of evaluating the vascular haemodynamic variation seen within cirrhotic patients. Differences in haemodynamics exhibited in hepatic vasculature has been appeared in previous reports to associate with the clinical severity of cirrhosis. In any case, the degree of changes in Doppler ultrasound flow parameters in foreseeing the clinical severity of liver cirrhosis stays uncertain.
Aim of Study: The purpose of this study was to evaluate the contribution of Doppler ultrasound of Hepatic Artery (HA) and Portal Vein (PV) with Child-Pugh (CP) score to assess the advancement of Hepatitis C Virus (HCV)-related liver cirrhosis.
Patients and Methods: One hundred patients with HCV-related liver cirrhosis divided according to CP score were included. Doppler ultrasound variables including Portal Vein (PV) diameter, Maximum Portal Vein Velocity (MPVV), and resistance index of the hepatic artery (HARI) were measured.
Results: There was significant association between the diameter of PV and the increase in CP score, which was statistically significant (p=0.000). A choice of 12mm as a cutoff point of PV diameter between CP, A and B revealed sensitivity of 96.9%, and specificity of 97.9%. The mean MPVV was statistically significantly higher with Child A (mean 17.1±1.6 cm/sec), compared to Child B and C (p= 0.000), and Child B (mean 14.1±1.9cm/sec) compared to Child C (mean 11.3±1.4cm/sec) (p=0.000). The mean HARI was statistically significantly lower with Child A and B (0.8cm/sec), compared to Child C (0.9cm/sec) (p=0.000). There was a strong negative correlation between HARI and MPVV which was statistically significant (p=0.000). There was a strong positive correlation between HARI and Child class and diameter of PV which was statistically significant (p=0.000).
Conclusion: PV diameter is a useful predictor of advance-ment of liver cirrhosis. Doppler measurements of MPVV, and HARI are useful in differentiating patients with CP, A and B from C.