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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:1491-1501 • 0278-4297

Technical Advance

High-Definition Flow Doppler Ultrasonographic Technique to Assess Hepatic Vasculature Compared With Color or Power Doppler Ultrasonography

Preliminary Experience

Se Hyung Kim, MD, Jeong Min Lee, MD, Young Jun Kim, MD, Jae Young Lee, MD, Joon Koo Han, MD and Byung Ihn Choi, MD

Department of Radiology (S.H.K., J.M.L., J.Y.L., J.K.H., B.I.C.) and Institute of Radiation Medicine (J.M.L., J.K.H., B.I.C.), Seoul National University Hospital, Seoul, Korea; and Department of Radiology, Konkuk University Hospital, Seoul, Korea (Y.J.K.).

Address correspondence to Jeong Min Lee, MD, Department of Radiology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. E-mail: leejm{at}radcom.snu.ac.kr

Objective. The purpose of this study was to introduce a new high-definition flow (HDF) Doppler technique and to compare its performance with those of color Doppler ultrasonography (CDU) and power Doppler ultrasonography (PDU) for assessment of hepatic vasculature in native and transplanted livers. Methods. High-definition flow was invented as a high-resolution bidirectional PDU technique. We obtained CDU, PDU, and HDF images of the hepatic artery (HA), portal vein (PV), and hepatic vein from 60 patients. They were divided into 2 groups: a liver transplantation group (group 1, n = 10) and a native liver group (group 2, n = 50). Two radiologists independently reviewed the cine images and graded them using a 4-point scale in terms of the clarity of the vessel margin and degree of depiction of the HA, flow filling, and flash artifacts. The degree of differentiation between the HA and PV was also evaluated. Flow directionality was recorded, and interobserver agreement was finally analyzed. Results. Moderate to almost perfect agreement was achieved between radiologists for all parameters of each ultrasonographic technique. High-definition flow was significantly superior to both CDU and PDU with respect to all analyzed items except the degree of flash artifacts (P < .05). With regard to flash artifacts, CDU was significantly better than either PDU or HDF. High-definition flow provided directional information, as did CDU. Conclusions. The HDF technique provides better resolution for depicting hepatic vessels as well as their margins with less blooming compared with conventional Doppler ultrasonography in both native and transplanted liver. It also provides solid directional flow information. One point of concern, however, is the frequency of flash artifacts compared with that on CDU.

Key Words: comparative studies • Doppler ultrasonography • liver ultrasonography • power Doppler ultrasonography

Abbreviations: CDU, color Doppler ultrasonography • HA, hepatic artery • HDF, high-definition flow • HV, hepatic vein • LT, liver transplantation • PDU, power Doppler ultrasonography • PV, portal vein

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.