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Portal hemodynamics by duplex Doppler sonography in different grades of cirrhosis
Y Chawla1, N Santa, R K Dhiman
1Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Portal hemodynamics, including portal flow velocity and rate, significantly decrease with worsening liver cirrhosis severity. This impacts patients with advanced disease and complications like ascites.
Area of Science:
- Hepatology
- Vascular Medicine
- Diagnostic Imaging
Background:
- The relationship between portal hemodynamics and cirrhosis grades remains underexplored.
- Understanding these changes is crucial for managing liver disease progression.
Purpose of the Study:
- To investigate the association between portal hemodynamics and the severity of liver cirrhosis.
- To assess portal vein diameter, flow velocity, and blood flow rate in relation to Child's classification.
Main Methods:
- Pulsed Doppler ultrasonography was employed to measure portal hemodynamics.
- 37 liver cirrhosis patients (Child's A, B, C) and 10 healthy controls were studied.
Main Results:
- No significant difference in portal vein diameter was observed between cirrhotics and controls.
- Significantly decreased portal flow velocity and blood flow rate were noted in Child's C and B cirrhosis patients, respectively.
- Ascites and encephalopathy were associated with lower portal flow velocities and rates.
Conclusions:
- Portal flow velocity and rate significantly decrease as liver cirrhosis severity (Child's grade) worsens.
- Doppler ultrasonography can detect hemodynamic alterations in advanced cirrhosis.
Abstract:
Not much is known about the relationship between portal hemodynamics and the grades of cirrhosis. Using pulsed Doppler ultrasonography, we studied portal vein diameter, portal flow velocity, and portal blood flow rate in 37 patients with liver cirrhosis (11 Child's A, 13 Child's B, and 13 Child's C) and 10 healthy controls. There was no difference in the maximum inner diameter of the portal vein in cirrhotics and controls. However, there was a significant decrease in the portal flow velocity in patients with Child's C cirrhosis, as compared to controls and patients with Child's A and Child's B cirrhosis. The portal blood flow rate in Child's B and Child's C cirrhosis was also significantly less as compared to controls and patients with Child's A cirrhosis. Patients with ascites and encephalopathy had significantly lower portal flow velocities and blood flow rate as compared to those without ascites and encephalopathy, respectively. This study indicates that portal flow significantly decreased in cirrhotic patients with worsening Child's grade of cirrhosis.