Brief Article
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World J Gastroenterol. Feb 28, 2013; 19(8): 1292-1298
Published online Feb 28, 2013. doi: 10.3748/wjg.v19.i8.1292
Abnormal splenic artery diameter/hepatic artery diameter ratio in cirrhosis-induced portal hypertension
Dao-Bing Zeng, Chuan-Zhou Dai, Shi-Chun Lu, Ning He, Wei Wang, Hong-Jun Li
Dao-Bing Zeng, Chuan-Zhou Dai, Shi-Chun Lu, Department of Hepatobiliary Surgery and You-An Liver Transplantation Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
Ning He, Wei Wang, Hong-Jun Li, Department of Radiology, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
Author contributions: Lu SC designed the study and prepared the protocol; Zeng DB, Dai CZ, Lu SC, He N, Wang W and Li HJ conducted the study; Zeng DB and Dai CZ contributed important reagents/analytic tools; Zeng DB did the data analysis; Zeng DB and Lu SC wrote the paper.
Supported by Grants from Beijing Municipal Health Bureau, No. 2011-2-18; the Capital Health Development Special Funds, No. 2011-2018-03
Correspondence to: Dr. Shi-Chun Lu, Department of Hepatobiliary Surgery and You-An Liver Transplantation Center, Beijing You-An Hospital, Capital Medical University, No. 8 Xitoutiao Road Youan Men Wai, Beijing 100069, China. lsc620213@yahoo.com.cn
Telephone: +86-10-83997160 Fax: +86-10-83997160
Received: September 5, 2012
Revised: December 24, 2012
Accepted: January 5, 2013
Published online: February 28, 2013
Processing time: 177 Days and 4 Hours
Abstract

AIM: To determine an optimal cutoff value for abnormal splenic artery diameter/proper hepatic artery diameter (S/P) ratio in cirrhosis-induced portal hypertension.

METHODS: Patients with cirrhosis and portal hypertension (n = 770) and healthy volunteers (n = 31) underwent volumetric computed tomography three-dimensional vascular reconstruction to measure the internal diameters of the splenic artery and proper hepatic artery to calculate the S/P ratio. The cutoff value for abnormal S/P ratio was determined using receiver operating characteristic curve analysis, and the prevalence of abnormal S/P ratio and associations between abnormal S/P ratio and major complications of portal hypertension were studied using logistic regression.

RESULTS: The receiver operating characteristic analysis showed that the cutoff points for abnormal splenic artery internal diameter and S/P ratio were > 5.19 mm and > 1.40, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 74.2%, 45.2%, 97.1%, and 6.6%, respectively. The prevalence of an abnormal S/P ratio in the patients with cirrhosis and portal hypertension was 83.4%. Patients with a higher S/P ratio had a lower risk of developing ascites [odds ratio (OR) = 0.708, 95%CI: 0.508-0.986, P = 0.041] and a higher risk of developing esophageal and gastric varices (OR = 1.483, 95%CI: 1.010-2.175, P = 0.044) and forming collateral circulation (OR = 1.518, 95%CI: 1.033-2.230, P = 0.034). After splenectomy, the portal venous pressure and maximum and mean portal venous flow velocities were reduced, while the flow rate and maximum and minimum flow velocities of the hepatic artery were increased (P < 0.05).

CONCLUSION: The prevalence of an abnormal S/P ratio is high in patients with cirrhosis and portal hypertension, and it can be used as an important marker of splanchnic hemodynamic disturbances.

Keywords: Portal hypertension; Cirrhosis; Splenic artery internal diameter; Proper hepatic artery internal diameter; Complications; Splenectomy