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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:1689-1696 • 0278-4297

Hemodynamic Features of Doppler Ultrasonography in Patients With Portal Hypertension

Intraoperative Direct Measurement of Portal Pressure in the Portal Venous System

Li Zhang, PhD, Yun-You Duan, PhD, Jin-Mao Li, MD and Ji-Kai Yin, PhD

Departments of Ultrasound Diagnosis (L.Z., Y.-Y.D.) and General Surgery (J.-M.L., J.-K.Y.), Tangdu Hospital, Fourth Military Medical University, Xi’an, China.

Address correspondence to Yun-You Duan, PhD, Department of Ultrasound Diagnosis, Tangdu Hospital, Fourth Military Medical University, Xin Si Road, Ba Qiao District, 710038 Xi’an, China. E-mail: duanyy{at}fmmu.edu.cn

Objective. The purpose of this study was to investigate the relationship between a series of portal hemodynamic parameters obtained with Doppler ultrasonography and portal pressure measured directly from patients with portal hypertension (PHT). Methods. Fifty-seven patients with a clinical diagnosis of PHT who accepted surgical therapy were investigated. The portal pressure was measured directly intraoperatively. Relevant parameters were compared and measured, including the hepatic artery pulsatility index (HAPI), hepatic artery resistive index (HARI), splenic artery resistive index, splenic artery pulsatility index (SpAPI), congestion index (CI) of the portal vein, hepatic buffer index (HBI), liver vascular index (LVI), and PHT index (PHI). Results. Doppler parameters for the postprandial HAPI, SpAPI, CI, LVI, HBI, and PHI were statistically different in patients with PHT and healthy control subjects (P < 0.05). The portal pressure was significantly correlated with the HARI (r = 0.699; P < .001), HAPI (r = 0.582; P < .001), LVI (r = –0.501; P = .003), HBI (r = 0.441; P = .009), and Child-Pugh scores (r = 0.589; P = .044). Conclusions. The HAPI, LVI, and HBI are indicative indices in patients with PHT, suggesting that color Doppler ultrasonography can be used as a noninvasive evaluation method for PHT degree. The changes in the HAPI, LVI, and HBI that accompany the increase in portal pressure can reflect hepatic resistance and hepatic artery buffer capacity accurately.

Key Words: cirrhosis • Doppler ultrasonography • hemodynamics • portal hypertension

Abbreviations: CI, congestion index • FPP, free portal pressure • HAPI, hepatic artery pulsatility index • HARI, hepatic artery resistive index • HBI, hepatic buffer index • HVPG, hepatic venous pressure gradient • LVI, liver vascular index • PHI, portal hypertension index • PHT, portal hypertension • PVVel, portal vein velocity • SpAPI, splenic artery pulsatility index • SpARI, splenic artery resistive index

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Copyright © 2007 by the American Institute of Ultrasound in Medicine.