Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 28, 2006; 12(36): 5853-5858
Published online Sep 28, 2006. doi: 10.3748/wjg.v12.i36.5853
Doppler study of hepatic vein in cirrhotic patients: Correlation with liver dysfunction and hepatic hemodynamics
KC Sudhamshu, Shoiichi Matsutani, Hitoshi Maruyama, Taro Akiike, Hiromitsu Saisho
KC Sudhamshu, Shoiichi Matsutani, Hitoshi Maruyama, Taro Akiike, Hiromitsu Saisho, Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. KC Sudhamshu, Liver Unit, Department of Medicine, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. sudhamshu@hotmail.com
Telephone: +977-1-4222865 Fax: +977-1-4215709
Received: February 21, 2006
Revised: August 5, 2006
Accepted: August 10, 2006
Published online: September 28, 2006
Abstract

AIM: To elucidate the significance of Doppler measurements of hepatic vein in cirrhotic patients and to correlate with liver dysfunction and hepatic hemodynamics.

METHODS: One hundred patients with liver cirrhosis and 60 non-cirrhotic controls were studied. Doppler waveforms were obtained from right hepatic vein and flow velocity measured during quiet respiration. Doppler measurements were also obtained from portal trunk, right portal vein and proper hepatic artery.

RESULTS: Hepatic vein waveforms were classified into three classical patterns. Flat waveform was uncommon. Mean hepatic vein velocity was significantly higher in cirrhotic patients (12.7 ± 6.4 vs 5.1 ± 2.1 and 6.2 ± 3.2 cm/s; P < 0.0001). The poorer the grade of cirrhosis, the higher was the mean velocity. Maximum forward velocity was never greater than 40 cm/s in controls. Degree of ascites was found to be highly correlated with mean velocity. “Very high” group (≥ 20 cm/s) presented clinically with moderate to massive ascites. Correlations between right portal flow and mean velocity was significant (P < 0.0001, r = 0.687).

CONCLUSION: Doppler waveforms of hepatic vein, which is independent of liver dysfunction, should be obtained during normal respiration. Mean hepatic vein velocity reflects the change in hepatic circulation associated with progression of liver cirrhosis. It can be used as a new parameter in the assessment of liver cirrhosis.

Keywords: Hepatic vein, Hepatic vein velocity, Doppler ultrasound