Doppler measurements: a surrogate marker of liver fibrosis?

Bernatik, T.; Strobel, D; Hahn, Eckhart G.; Becker, Dirk

doi:10.1097/00042737-200204000-00008

Cited by 68 publications

(57 citation statements)

References 20 publications

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“…Published data on Doppler US methods used in liver fibrosis differ, and thus the clinical usefulness of Doppler flow measurements for the diagnosis of hepatic fibrosis remains controversial. 13,31,32 Quantitative measures include portal vein blood volume, mean or maximum portal vein velocity, portal blood flow, congestion index of the portal vein, effective portal liver perfusion, and resistance indices of the liver and the spleen 33,34 (Figure 2), including our results compared to the results of the previous investigators in the field. Additionally, pulse wave Doppler can be applied to obtain waveforms (phasicity) of the portal vein and hepatic vein.…”

Section: Discussionmentioning

confidence: 85%

“…Liver blood flow undergoes complex changes with the progression of chronic liver disease, which should be detected with dopplerographic examinations. Characteristic features of liver cirrhosis are decreasing portal bloodflow velocity, disappearance of pulsatility, change in flow detection in the portal vein from hepatopetal to hepatofugal in more severe cases, [10][11][12][13][14] and increase of resistive index in the hepatic artery. [15][16][17] The most characteristic dopplerographic sign has been suggested: changes in hepatic vein Doppler curve waveform from triphasic to biphasic and monophasic.…”

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confidence: 99%

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The prediction of liver disease status using Doppler observations of the hepatic and portal venous system compared with liver biopsy in patients with chronic hepatitis C

Zytoon¹,

Allah²,

Faisal³

2014

RRFU

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Section: Discussionmentioning

confidence: 85%

mentioning

confidence: 99%

The prediction of liver disease status using Doppler observations of the hepatic and portal venous system compared with liver biopsy in patients with chronic hepatitis C

Zytoon¹,

Allah²,

Faisal³

2014

RRFU

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“…Bernatik et al [37] reported that V MAX and V TAM velocities are reduced at end-stage fibrosis, while DPI does not change significantly and progression of liver fibrosis is associated with a continuous increase in HA resistive index (RI), suggesting that Doppler parameters are not useful in assessing the stage of liver fibrosis. In our study, although the mean HA RI value was significantly increased (P = 0.013) in CIR group compared to CVH group, it was not affected in CVH patients at different fibrosis stages.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, positive correlation studies have usually referred to the velocity ratio of hepatic www.wjgnet.com artery to portal vein or the resistive index in hepatic artery. However, the role of CDU remains controversial regarding the reproducibility [33][34][35][36] and the statistical significance [37,38] of the measurements in hepatic fibrosis and cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonography in differentiation between chronic viral hepatitis and compensated early stage cirrhosis

Iliopoulos

Vlychou²,

Karatza³

et al. 2008

WJG

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minate CVH from CIR. The alternative Doppler indexes can accurately differentiate chronic virus hepatitis from cirrhosis. These indexes can be used in monitoring chronic virus hepatitis and avoiding unnecessary biopsies. INTRODUCTIONChronic viral hepatitis, mainly caused by hepatitis virus B or C, results in liver parenchyma damage and inflammation and may lead to fibrosis, cirrhosis and/or hepatocellular carcinoma [1][2][3] . Cirrhosis often occurs as an indolent disease and a lot of patients remain asymptomatic [4,5] until the occurrence of decompensation, and are characterised by portal hypertension, variceal bleeding, ascites and hepatic encephalopathy.Liver biopsy is the gold standard for diagnosis and determination of the fibrosis and necroinflammatory changes in chronic viral hepatitis and cirrhosis. However, the use of biopsy in clinical practice has some limitations related to sample errors with an estimated false negative percentage of 24% morbidity and mortality in series of blind biopsies [6] and complications [7] . The non-invasive assessment of chronic liver disease has been attempted by various research groups using either clinical signs [8,9] , gray scale [10][11][12][13][14][15] and colour Doppler ultrasound (CDU) signs and indexes [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , or biochemical parameters in the blood [9] . The use of CDU in diagnosis and staging of chronic viral liver disease has been based on the hypothesis that alteration in liver haemodynamics due to chronic inflammatory changes may indirectly reflect histological alterations. Therefore, positive correlation studies have usually referred to the velocity ratio of hepatic RESULTS: ROC analysis showed that PV congestion index, PV D/VTAM and HA/PV VTAM indices had the best sensitivity and specificity in discriminating CVH from CIR.Stepwise discriminant analysis showed that 88.9% of the originally grouped cases could be correctly classified by the three qualitative and four quantitative variables selected as statistically significant predictors. Among the CVH patients who underwent to biopsy, statistically significant changes were found in those at fibrosis stage 5 compared to fibrosis stages 1-4.

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“…Ancak biyopsi invaziv bir işlemdir ve komplikasyon riski mevcuttur. Ayrıca bazı hastalarda yalancı sonuç verebilmektedir (3). Bu nedenler, karaciğer fibrozis evresinin takibinde biyopsinin rutin kullanımını kısıtlamaktadır.…”

Section: Introductionunclassified

The Value of Fibrosis Index in Discrimination of Chronic Hepatitis and Cirrhosis

Söker¹,

Gülek²,

Öztürk³

et al. 2017

Haseki

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ÖzAmaç: Kronik hepatit ve siroz ayrımında Doppler ultrasonografi (US) ve fibrozis indeksinin değerini araştırmaktır.Yöntemler: Bu çalışmaya 67 hepatit B ve C'si olan ancak siroz gelişmeyen hasta ve 28 siroz hastası katıldı. Tüm hastalara karaciğere yönelik Doppler US yapıldı. Kantitatif Doppler parametreleri elde edildi ve fibrozis indeksi hesaplandı. Sonuçlar istatistiksel olarak karşılaştırıldı ve kronik hepatit ve siroz gruplarını ayırmak için fibrozis indeks eşik değeri elde edildi. Methods: Sixty-seven non-cirrhotic viral hepatitis B and C patients and 28 cirrhotic patients were included in this study. All patients were examined by liver Doppler US. Quantitative Doppler parameters were obtained and fibrosis index was calculated. The results were evaluated statistically and a cut-off value for fibrosis index was obtained to differentiate between chronic hepatitis and cirrhosis groups.

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Doppler measurements: a surrogate marker of liver fibrosis?

Abstract: Doppler measurements of the portal vein, hepatic artery and hepatic vein(s) are not a valid surrogate marker of liver fibrosis. Nor are Doppler measurements a useful method to estimate the degree of liver fibrosis.

Cited by 68 publications

References 20 publications

The prediction of liver disease status using Doppler observations of the hepatic and portal venous system compared with liver biopsy in patients with chronic hepatitis C

The prediction of liver disease status using Doppler observations of the hepatic and portal venous system compared with liver biopsy in patients with chronic hepatitis C

Ultrasonography in differentiation between chronic viral hepatitis and compensated early stage cirrhosis

The Value of Fibrosis Index in Discrimination of Chronic Hepatitis and Cirrhosis

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