Alpay Haktanir, Presenter: Nothing to Disclose

Birsen Songül Cihan MD, Abstract Co-Author: Nothing to Disclose

Çetin Çelenk, Abstract Co-Author: Nothing to Disclose

Murat Acar, Abstract Co-Author: Nothing to Disclose

Bumin Degirmenci, Abstract Co-Author: Nothing to Disclose

The aim of this study is to assess the value of color duplex Doppler sonography (CDUS) in the follow up of progression in chronic viral hepatitis (CVH) and in the diagnosis and grading of cirrhosis.

Ninety-nine patients (36 CVH, 63 cirrhosis) and 30 controls were examined by CDUS. The parameters evaluated by CDUS were the sizes of liver and spleen; portal (PVD) and splenic vein (SVD) diameters; pulsatility score (PVP), blood flow, direction and flow velocity (PVV) of portal vein; pulsatility (HAPI) and resistance (HARI) indices of hepatic artery; hepatic vascular index (HVI); modified hepatic index (MHI); loss of the reverse flow component (LRFC), and existence of focal flow acceleration in the hepatic veins. In CVH, differences between subgroups, which were divided according to inflammation and fibrosis, were observed with regard to each Doppler parameter. Cirrhotic patients were observed for Child classification, collateral and ascites formation.

HARI and HAPI were significantly greater while HVI and MHI were smaller for cirrhosis than others and for CVH than controls. PVD, SVD, and spleen sizes of cirrhotics were greater and mean PVV was smaller than others.HARI increased with degree of inflammation while MHI decreased in severe inflammation. MHI and PVV decreased with the advance of fibrosis. LRFC frequency in advanced fibrosis was larger than in early fibrosis of CVH. It was also greater in steatosis than in normal echogenicity livers.Liver sizes in Child C were smaller than A and B. Collateral vessels and ascites were found to be relating with the LRFC in cirrhotics. Liver sizes in abundant ascites were smaller than others. For the cirrhosis cohort, HAPI exceeded 1.30, HVI less than 15 cm/sec, MHI less than 29 cm/sec had a sensitivity of 90%, 81% and 83%, respectively. The specificity of all parameters was 100%. LRFC was more frequent in abundant ascites group than others.

We suggest that CDUS is useful in follow up of progression in inflammation and fibrosis of CVH. Although CDUS has a high diagnostic accuracy in cirrhosis, it has a limited role in clinical grading.

Haktanir, A, Cihan, B, Çelenk, Ç, Acar, M, Degirmenci, B, Value of Doppler Sonography in the Assessment of Progression in Chronic Hepatitis and in the Diagnosis and Staging of Cirrhosis.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4403661.html