Comparing Diameter of Hepatic Portion of Inferior Vena Cava During Normal Breathing in Normal Individuals Versus Cirrhotic Patients: Case Control Study

Abstract

A non invasive ultrasound technique has been proposed as a mean of detection of early fibrosis by measuring changes in the diameter of the hepatic inferior vena cava (IVC). Objectives: To determine the mean diameter of hepatic portion of inferior vena cava and mean reduction in its diameter by inspiration in normal and cirrhotic patients using USG. Study Design: Case control study. Methodology: This study (n=60) was conducted after ethical review committee’s (ERC) approval from April-October 2018 at Department of Radiology, Military Hospital Rawalpindi. Patients with stage 5 and 6 of cirrhosis were taken as cases. Controls had sonographically normal livers. The maximal diameter of IVC was measured during normal breathing first followed by a deep breath. Statistical analysis: Data was analyzed by SPSS, v-20. Parameters were measured by applying t-test with p≤0.05 as significant. Results: The IVC diameter during deep inspiration was 1.217±0.168 cm and 1.711±0.422 cm among controls and cirrhotic cases respectively (p= 0.00). The mean IVC diameter decrease was 1.02±0.25 cm and 0.03±0.02 cm by inspiration among controls and cases respectively having statistically significant p-value (<0.05). Conclusion: We concluded that stiffness of the hepatic parenchyma have caused the physiological changes in the diameter of IVC enhanced by deep respiration. Thus, it can be used as a tool for evaluation of cirrhotic patients. Key Words: Cirrhosis, Hepatic Portion of Inferior Vena Cava, Liver and Sonography