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Hepatic arterial pulsatility index in cirrhosis: correlation with portal pressure

A W Schneider1, J F Kalk, C P Klein

  • 1Department of Gastroenterology, Heinz Kalk-Hospital, Bad Kissingen, Germany.

Journal of Hepatology
|June 12, 1999
PubMed

Insights

In cirrhosis patients, the hepatic arterial pulsatility index measured by duplex sonography is higher and correlates with hepatic venous pressure gradient, suggesting it can assess portal hypertension noninvasively.

Area of Science:

  • Hepatology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Noninvasive assessment of hepatic artery vascular resistance is possible using duplex sonography to determine pulsatility index.
  • Cirrhosis is associated with altered hepatic hemodynamics and portal hypertension.

Purpose of the Study:

  • To investigate the relationship between the hepatic arterial pulsatility index (PI) and the hepatic venous pressure gradient (HVPG) in patients with cirrhosis.
  • To evaluate the utility of duplex sonography in assessing portal hypertension in cirrhosis.

Main Methods:

  • Duplex sonography was used to measure hepatic arterial pulsatility index and portal blood flow velocity in 50 cirrhosis patients and 20 controls.
  • Hepatic venous pressure gradient was measured in fasting cirrhosis patients immediately before sonographic measurements.

Main Results:

  • Hepatic arterial pulsatility index was significantly higher in cirrhosis patients compared to controls (1.14±0.18 vs. 0.92±0.1; p<0.001).
  • A significant positive correlation was observed between hepatic arterial pulsatility index and hepatic venous pressure gradient (r=0.7; p<0.001).
  • Weak correlations were found between hepatic arterial pulsatility index and Child-Pugh score (r=0.49; p<0.01) and between portal blood flow velocity and HVPG (r=-0.48; p<0.01).

Conclusions:

  • Hepatic arterial vascular resistance increases with rising portal pressure in cirrhosis.
  • Duplex sonographic determination of hepatic arterial pulsatility index may serve as a valuable noninvasive tool for evaluating portal hypertension in cirrhosis.
Abstract

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