This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Haktanir, A. Articles by Cihan, S. Search for Related Content PubMed PubMed Citation Articles by Haktanir, A. Articles by Cihan, S.

Value of Doppler Sonography in Assessing the Progression of Chronic Viral Hepatitis and in the Diagnosis and Grading of Cirrhosis

Alpay Haktanir, MD, Birsen Songül Cihan, MD, Çetin Çelenk, MD and ener Cihan, MD

Department of Radiology, Ondokuz Mayis University Medical Faculty, Samsun, Turkey.

Address correspondence and reprint requests to Alpay Haktanir, MD, Afyon Kocatepe Üniversitesi Tip Fakültesi, Kirmizi Hastane, 03200 Afyon, Turkey. E-mail: dralpay{at}yahoo.com

Objective. The purpose of this study was to evaluate the value of Doppler sonography in assessing the progression of chronic viral hepatitis and in the diagnosis and grading of cirrhosis. Methods. Abdominal sonographic and liver Doppler studies were performed in 3 groups: 36 patients with chronic viral hepatitis, 63 patients with cirrhosis, and 30 control subjects with no evidence of liver disease. A series of Doppler indices of hepatic vascularity, including portal vein velocity, portal vein pulsatility score, flow volume of the portal vein, resistive and pulsatility indices of the hepatic artery, modified hepatic index, hepatic vascular index, waveform of the hepatic vein, and focal acceleration of flow, were measured and correlated with liver and spleen size, portal and splenic vein diameter, and presence of ascites and collateral vessels. These indices were compared across the 3 study groups and within the patient groups with respect to presence of inflammation, fibrosis, and steatosis, as determined by histologic evaluation. Results. The most useful indices were portal vein velocity, the modified hepatic index, and nontriphasic flow in the hepatic vein, which were helpful in distinguishing patients from control subjects. Hepatic vascular and modified hepatic indices were useful for differential diagnosis of cirrhosis and chronic viral hepatitis. However, all measurements were limited in their ability to determine the severity of chronic hepatitis. Conclusions. Doppler sonography is sensitive to hemodynamic alterations resulting from inflammation and fibrosis, and if sonography is the study of choice to follow the progression of hepatitis, it will not be adequate without Doppler imaging. Doppler sonography has high diagnostic accuracy in cirrhosis despite some false-positive conditions. However, it has a limited role in clinical grading.

Key Words: chronic hepatitis • cirrhosis • hepatic arterial index • hepatic vein • portal vein

Abbreviations: CVH, chronic viral hepatitis • HAI, histologic activity index • HAPI, hepatic artery pulsatility index • HARI, hepatic artery resistive index • HVI, hepatic vascular index • MHI, modified hepatic index • PVP, portal vein pulsatility • PVV, portal vein velocity

This article has been cited by other articles:

				R.-B. Hsu, C.-I Chang, F.-Y. Lin, N.-K. Chou, N.-H. Chi, S.-S. Wang, and S.-H. Chu Heart transplantation in patients with liver cirrhosis. Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 307 - 312. [Abstract] [Full Text] [PDF]