Hepatic venography and wedge hepatic vein pressure measurements in diffuse liver disease

Ninety patients with chronic diffuse liver disease were evaluated with free hepatic venography, wedge hepatic venography, hepatic vein pressure measurements, and liver biopsy. Free hepatic venograms were normal and minimally pruned in patients with hepatic sarcoidosis and fatty liver due to alcohol, and their biopsies showed little or no fibrosis. Pruning of hepatic vein branches on free hepatic venography correlated well with the corrected wedged hepatic vein pressure and with the degree of fibrosis in patients with alcoholic hepatitis, alcoholic cirrhosis, and postnecrotic cirrhosis. Free hepatic venography correlated better with hemodynamic measurements and fibrosis than did wedge hepatic venography. Free hepatic venography is a reliable predictor of the presence and degree of hepatic fibrosis and may be a useful alternative to liver biopsy in patients with clotting disorders.