The value of Doppler ultrasound in cirrhosis and portal hypertension

T Kok*, EJ van der Jagt, EB Haagsma, CMA Bijleveld, PLM Jansen, WJ Boeve

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Abstract

    Background: Cirrhosis and portal hypertension affect the flow profile of the liver vasculature. In these conditions Doppler ultrasound can provide important information on the hemodynamics of the portal venous system, the hepatic artery and the hepatic veins. Methods: The value of Doppler ultrasound in the assessment of the patient with cirrhosis and portal hypertension was determined by reviewing the Literature. Results: Portal venous blood how becomes reversed with advanced portal hypertension. Reversed flow is also demonstrated in patients with veno-occlusive disease and portosystemic shunts. Despite general agreement that portal flow velocity is decreased in cirrhotic patients, the absolute values of portal flow velocity in both healthy subjects and cirrhotic patients Vary considerably. Errors in Doppler measurements, observer variability and collateral pathways contribute to these variations. Furthermore, portal blood flow is influenced by numerous factors such as changes in the body position, phase of respiration, timing of meals, exercise and cardiac output. Finally, portal flow may be unaltered due to a combination of high inflow from the splanchnic organs and increased resistance within the liver. High resistive index of the hepatic artery is seen in patients with end-stage liver disease, particularly in children with severe cirrhosis secondary to biliary atresia. However, hepatic artery dow remains normal in mast patients. Abnormal hepatic vein flow profiles are seen in patients with cirrhosis, but dampening or flattening of the flow profile has a multifactorial origin (Budd-Chiari, metastases, ascites) and can be observed in healthy subjects. Conclusions: Although many factors may affect the accuracy of volume flow and velocity measurements and the flow profile of the liver vasculature may change in different situations, Doppler ultrasound is useful in the assessment of the patient with cirrhosis and portal hypertension.

    Original languageEnglish
    Pages (from-to)82-88
    Number of pages7
    JournalSCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
    Volume34
    Publication statusPublished - 1999
    Event13th Annual Gastroenterology Symposium on Highlights of Gastroenterology in The Netherlands 1998 - , Netherlands
    Duration: 1-Jan-1998 → …

    Keywords

    • cirrhosis
    • Doppler ultrasound
    • hepatic artery
    • hepatic vein
    • portal hypertension
    • portal vein
    • ORTHOTOPIC LIVER-TRANSPLANTATION
    • BUDD-CHIARI SYNDROME
    • VEIN WAVE-FORM
    • HEPATIC-ARTERY
    • ACUTE REJECTION
    • VENOUS SYSTEM
    • FLOW VELOCITY
    • DIAGNOSIS
    • ULTRASONOGRAPHY
    • SONOGRAPHY

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