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Intra- and extrahepatic arterial resistances in chronic hepatitis and liver cirrhosis
F Piscaglia1, S Gaiani, G Zironi
1Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Italy.
Insights
Doppler ultrasound reveals increased hepatic artery resistance index (RI) in patients with chronic hepatitis and liver cirrhosis when measured in intrahepatic branches. This finding is influenced by liver disease severity and patient age.
Area of Science:
- Hepatology
- Radiology
- Vascular Medicine
Background:
- Chronic liver diseases, including chronic hepatitis (CH) and liver cirrhosis (LC), can alter hepatic hemodynamics.
- Noninvasive assessment of hepatic artery resistance index (RI) using Doppler ultrasound (US) is crucial for evaluating liver disease progression.
Purpose of the Study:
- To investigate changes in hepatic artery RI in patients with CH and LC compared to controls.
- To determine the influence of disease severity, measurement site (porta hepatis vs. intrahepatic branches), and aging on hepatic artery RI.
Main Methods:
- Doppler ultrasound was used to measure hepatic artery RI in 30 CH patients, 84 LC patients, and 42 controls.
- Measurements were taken at the porta hepatis and in intrahepatic branches.
- Correlation analyses were performed with age and esophageal varices in LC patients.
Main Results:
- Intrahepatic RI was significantly different among LC, CH, and control groups (0.731, 0.690, 0.643, p < 0.05).
- RI at the porta hepatis did not differ significantly across groups.
- Intrahepatic RI correlated positively with age in LC and control groups and with esophageal varices in LC patients.
Conclusions:
- Increased hepatic artery RI in chronic liver diseases is detectable in intraparenchymal branches.
- Age-related increases in hepatic artery RI should be considered in future research and clinical assessments.
Abstract:
Thirty patients with chronic hepatitis (CH), 84 with liver cirrhosis (LC) and 42 controls, underwent noninvasive measurement of hepatic artery resistance index (RI) by means of Doppler ultrasound (US), at the porta hepatis and in the intrahepatic branches, in order to investigate possible changes related to: (a) the liver disease; (b) the site of measurement; and (c) ageing. The intrahepatic RI differed among LC, CH and controls (0.731, 0.690 and 0.643, p < 0.05), whereas the RI at the porta hepatis did not (0.754, 0.748 and 0.729, respectively). Intrahepatic RI correlated with age in LC (r = 0.51, p < 0.0001) and in controls (r = 0.49, p < 0.001). In LC, it correlated also with the presence and size of esophageal varices (r = 0.32, p < 0.05). In conclusion, an increase of hepatic artery RI in chronic liver diseases can be demonstrated when assessed in the intraparenchymal branches. The increase of hepatic artery RI with ageing should be considered in future studies.