Altered Doppler flow patterns in cirrhosis patients: an overview

Abstract

Doppler ultrasonography of the hepatic vasculature is an integral part of evaluating precirrhotic and cirrhotic patients. While the reversal of the portal venous flow is a well-recognized phenomenon, other flow patterns, although not as easily understood, may play an important role in assessing the disease status. This article discusses the different characteristic flow patterns observed from the portal vein, hepatic artery, and hepatic vein in patients with liver cirrhosis or related complications and procedures. Knowledge of these different flow patterns provides additional information that may reinforce the diagnosis of cirrhosis, help in staging, and offer prognostic information for determining the direction of therapy. Doppler ultrasonography is invaluable when liver transplantation is being considered and aids in the diagnosis of cirrhosis and portal hypertension.

Phase‐contrast MR flow imaging: A tool to determine hepatic hemodynamics in rats with a healthy, fibrotic, or cirrhotic liver

“…[32][33][34] Furthermore, the portal cross-sectional area may increase with rising portal pressure, but the determination of the portal cross-sectional area does not seem to be a reliable diagnostic indicator for portal hypertension. [35][36][37] In the present study, the portal cross-sectional area of the rats remained constant even in severely diseased rats. It could be likely that the increase in portal pressure in the tested animal model is not pronounced enough to cause a dilation of the portal vein.…”

“…According to clinical studies, portal perfusion in humans is altered depending on the degree of liver fibrosis and with advanced portal hypertension the portal blood flow may even become reversed . Furthermore, the portal cross‐sectional area may increase with rising portal pressure, but the determination of the portal cross‐sectional area does not seem to be a reliable diagnostic indicator for portal hypertension …”

Doppler ultrasonography: A non‐invasive method used to diagnose and follow up patients with chronic hepatitis C

“…In fact, HARI values have shown a difference between the healthy and chronic liver disease subjects. 21 This last finding is probably due to the great interpersonal variability of these indices. 20 HARI values > 0.77 may identify the development of significant fibrosis and cirrhosis, with a sensitivity of 70% and a specificity of 68%, but there is no association between the range of values of this index and different degrees of fibrosis due to different aetiologies.…”

Ultrasound approach to the Wilson’s disease

“…Early diagnosis of WD and alteration of blood flow speed and pattern may help prevent the associated detrimental effects, including variceal bleeding, hepatic encephalopathy, and portal vein thrombosis [11].…”