Association Between Portal Vein Color Doppler Findings and the Severity of Disease in Cirrhotic Patients With Portal Hypertension

authors:

avatar Puneet Mittal 1 , * , avatar Ranjana Gupta 2 , avatar Gaurav Mittal 2 , avatar Vishal Kalia 3

Department of Radiodiagnosis, Punjab Institute of Medical Sciences, drpuneetmittal@gmail.com, India
Department of Radiodiagnosis, Punjab Institute of Medical Sciences, India
Department of Radiodiagnosis, Dayanad Medical College and Hospital, India

how to cite: Mittal P, Gupta R, Mittal G, Kalia V. Association Between Portal Vein Color Doppler Findings and the Severity of Disease in Cirrhotic Patients With Portal Hypertension. I J Radiol. 2011;8(4): 211-217. https://doi.org/10.5812/iranjradiol.4489.

Abstract

Background: Doppler ultrasound is the accepted gold standard for assessing direction of flow in the portal vein (PV). Moreover, it is non-invasive; therefore, it is well accepted by the patients and does not interfere with flow hemodynamics.
Objectives: The present study was aimed to evaluate the association between color Doppler findings and the severity of portal hypertension in patients with cirrhosis.
Patients and Methods: The study group included 50 patients referred for ultrasound (US) evaluation over a period of six months from March to August, 2007. The patients were divided into three groups (Child’ A, B and C) based on Child Pugh classification. The direction of flow in the main portal vein (hepatopetal or nonhepatopetal) and peak venous velocity (PVV) in the main portal vein were measured and correlated with the presence or absence of ascites, splenomegaly, splenic and esophageal varices (assessed by Doppler US). These findings were correlated with clinical features and laboratory findings (using Child Pugh’s criteria).
Results: There was significant association between the decrease of peak portal venous velocity (PVV) and the increase in Child Pugh score. Hepatofugal flow was seen only in patients with more advanced disease. There was also significant association between PVV and splenic varices and ascites, while PVV was not affected by the presence or absence of esophageal varices or splenomegaly. Presence of a recanalized umbilical vein (UV) was associated with increased PVV even in advanced disease.
Conclusions: Color Doppler is an excellent modality for detecting and characterizing the complex hemodynamics of portal hypertension in cirrhosis and they correlate with the clinical stage of disease.


  • Implication for health policy/practice/research/medical education:
    This article approaches the association of portal flow velocity with the severity of the disease in cirrhotic patients with portal hypertension which may help radiologists and clinicians to better understand portal hemodynamics in these patients and interpretation of various Doppler findings.
  • Please cite this paper as:
    Mittal P, Gupta R, Mittal G, Kalia V. Association Between Portal Vein Color Doppler Findings and the Severity of Disease in Cirrhotic Patients With Portal Hypertension. Iran J Radiol. 2011;8(4):211-7. DOI: 10.5812/iranjradiol.4489

Copyright © 2011, Tehran University of Medical Sciences and Iranian
Society of Radiology. Published by Kowsar Corp. All rights reserved.


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