Doppler Study Of Hepatic Vein In Cirrhotic Patients: Correlation With Child-Pugh Score And Hepatic Hemodynamics

Aim:To elucidate the significance of Doppler measurements of hepatic vein in cirrhotic patients and to correlate with Child-Pugh Score and hepatic hemodynamics.Methords:35 patients with liver cirrhosis and 47 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 and proper hepatic artery.Result:1. Hepatic vein waveforms changed in patients with liver cirrhosis and chronic hepatitis, but the appearance of waveform was independent of the degree of severity of liver dysfunction as graded by Child-Pugh score in cirrhotic patients.2. Mean hepatic vein velocity was significantly higher in cirrhotic patients (15.63±5.08 vs 8.56±4.38 and 7.65±2.21 cm/s; P < 0.0001). The poorer the grade of cirrhosis, the higher was the mean velocity. Maximum forward velocity was also higher in cirrhotic patients than in controls.3. Degree of ascites was found to be highly correlated with mean velocity."Very high"group (≥20cm/s) presented clinically with moderate to massive ascites.4. Correlations between right portal flow and mean velocity was significant (P<0.0001, r =0.912).Conclusion:Doppler waveforms of hepatic vein is independent of liver dysfunction. 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.