Hepatic artery augmented velocity index and steatosis/fibrosis in MAFLD

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common cause of chronic liver disease, and non-invasive methods are essential for evaluating hepatic steatosis and fibrosis. This study aimed to investigate the relationship between the hepatic artery augmented velocity index (HAVI) and the severity of hepatic steatosis and fibrosis in patients with MAFLD.

This retrospective study included 197 patients who underwent hepatobiliary ultrasonography (US), shear wave elastography (SWE), and Doppler US between January 2021 and November 2023. HARI was calculated using the standard formula [(PSV - EDV)/PSV], while HAVI was calculated as [(LSV - ESV)/(PSV - EDV)]. Liver stiffness (kPa), biochemical parameters, and the FIB-4 score were compared among steatosis grades.

Patients were divided into four groups based on hepatic steatosis grade. Body mass index, ALT, AST, GGT, total cholesterol, and triglyceride levels increased significantly with steatosis severity (p < 0.01). FIB-4 differed significantly between grades (p < 0.01), whereas kPa did not show a significant difference (p = 0.11). HAVI values increased significantly with steatosis severity (p < 0.01), while HARI did not differ. HAVI showed strong positive correlations with kPa (r = 0.66, p < 0.01) and moderate correlations with ALT, AST, and GGT. No significant correlations were found between HAVI and platelet count, albumin, or triglycerides.

HAVI showed significant associations with steatosis severity and non-invasive fibrosis markers, whereas no such relationships were observed for HARI in this study. These preliminary findings suggest that HAVI could be further investigated as a potential Doppler-derived parameter to support non-invasive evaluation of liver parenchymal and microvascular alterations in patients with MAFLD.