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A Doppler waveform index to characterize hepatic vein velocity pattern and evaluate hepatic fibrosis
Author(s) -
Pedersen Jan Fog,
Madsen Lone Galmstrup,
Larsen Vibeke Andrée,
Hamberg Ole,
Horn Thomas,
Federspiel Birgitte,
Bytzer Peter
Publication year - 2008
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20446
Subject(s) - medicine , cirrhosis , hepatic fibrosis , fibrosis , liver biopsy , biopsy , radiology , ultrasound , doppler effect , gastroenterology , nuclear medicine , pathology , physics , astronomy
Purpose. To describe a Doppler waveform index representing the hepatic vein flow velocity pattern and to examine its relationship to the degree of hepatic fibrosis. Methods. Doppler waveforms were obtained in 66 patients scheduled for percutaneous liver needle biopsy and categorized as normal (with a retrograde flow phase) or abnormal (without retrograde flow). Waveforms were also characterized using a hepatic vein waveform index (HVWI): (maximum − minimum velocity)/(maximum velocity). Biopsy specimens were graded for fibrosis. Results. There was a highly significant decrease in HVWI with increasing fibrosis score in the biopsy ( p < 0.001, Jonckheere trend test). The biopsy showed cirrhosis in 14 of 29 patients (48%) with absent retrograde flow and 5 of 37 patients (14%) with a normal flow pattern. Using HVWI as the criterion, cirrhosis was present in 13 of 21 (62%) patients with HVWI < 0.75, in 6 of 31 (19%) patients with 0.75 < HVWI < 1.50, and in none of 14 (0%) patients with HVWI > 1.50. Conclusions. HVWI is inversely correlated to the degree of liver fibrosis and may be more efficient than the presence or absence of retrograde flow in diagnosing and grading hepatic fibrosis. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.