Doppler Ultrasound in Liver Cirrhosis: Correlation of Hepatic Artery and Portal Vein Measurements With Model for End-Stage Liver Disease Score

Park, Hee Sun; Desser, Terry S.; Jeffrey, R. Brooke; Kamaya, Aya

doi:10.7863/ultra.16.03107

Cited by 20 publications

(26 citation statements)

References 21 publications

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“…Likewise, other series and our data showed that alcoholic hepatitis and severe end-stage liver disease may also cause elevated HAV. 7,8 However, our study did show that many hospitalized patients with HAV > 200 cm/s did not have a primary diagnosis of hepatobiliary disease. However, we found that all groups had elevated liver enzymes.…”

Section: Discussionmentioning

confidence: 51%

“…However, a more recent publication about cirrhotic patients with endstage liver disease, using a threshold of 120 cm/s, showed a sensitivity of 42% and a specificity of 90% in predicting a MELD score > 19. 8 Tse et al 9 showed that HAV greater than 100 cm/s was 79% sensitive (Figure 1c). Like Loehfelm et al, 5 we demonstrated that elevated HAV occurs in the setting of acute cholecystitis.…”

Section: Discussionmentioning

confidence: 92%

“…Other studies have shown that elevated HAV occurs in various hepatobiliary diseases, including acute alcoholic hepatitis, choledocholithiasis, and in patients with elevated MELD (model for end-stage liver disease) scores. [5][6][7][8][9] Most of these studies have focused on the use of HAV in specific hepatobiliary disease states such as acute cholecystitis, cholangitis, or hepatitis. We have measured hepatic arterial velocities as part of our routine abdominal ultrasonographic examinations for over 3 years and noticed that some patients with marked elevation of HAV had a variety of different primary diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Markedly elevated hepatic arterial velocity—HAV greater than 200 cm/s—is not specific to hepatobiliary disease

Ramirez

McGahan

Loehfelm

et al. 2020

J of Clinical Ultrasound

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Objective: The aim of the study was to review the different etiologies and outcomes of patients with hepatic artery velocities greater than 200 cm/s. Methods: This retrospective study included 88 hospitalized patients in whom anglecorrected proper hepatic artery flow velocities greater than 200 cm/s were obtained during an abdominal ultrasonographic examination. Peak systolic hepatic artery flow velocities, hepatic artery resistance index, and portal vein flow velocities were evaluated. The patients were then allocated to one of four groups based on their primary underlying diagnosis: structural liver disease, nonstructural liver disease, generalized infection, or miscellaneous. Results: The median hepatic artery velocity was similar for all groups, ranging from 226 to 238 cm/s. The maximum portal venous velocities were not significantly different between groups. No lab values were statistically different between the groups, except total bilirubin that was greater in the nonstructural liver disease group (8 mg/ dL). Overall, 9/88 (10.2%) of patients with elevated hepatic artery velocity died within 30 days of their ultrasonographic examination. Conclusion: Elevated hepatic artery velocity greater than 200 cm/s in hospitalized patients is not specific to primary hepatobiliary disease but may indicate acute hepatic dysfunction from other causes such as infection or sepsis.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Markedly elevated hepatic arterial velocity—HAV greater than 200 cm/s—is not specific to hepatobiliary disease

Ramirez

McGahan

Loehfelm

et al. 2020

J of Clinical Ultrasound

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“…It is noteworthy that a recently published study indicated that elevated hepatic arterial velocity is positively correlated with increasing a model for end-stage liver disease and can be used as a useful biomarker for evaluating cirrhotic patients. [ 21 ] In addition, in cirrhotic children due to biliary atresia, RI is correlated with the degree of liver cirrhosis. [ 22 ] The known etiologies of cirrhosis in children include biliary atresia, choledochal cyst, primary sclerosing cholangitis, autoimmune hepatitis, alpha1-antitrypsin deficiency, galactosemia, Wilson's disease, cystic fibrosis, Alagille syndrome, and hepatitis.…”

Section: Discussionmentioning

confidence: 99%

Doppler assessment of children with liver cirrhosis and portal hypertension in comparison with a healthy control group: An analytical cross-sectional study

Riahinezhad¹,

Rezaei²,

Saneian

et al. 2018

J Res Med Sci

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Background:Doppler ultrasonography (Doppler US) plays an important role in evaluating patients with liver cirrhosis. This study aims to investigate the hemodynamic alterations of hepatic artery and portal vein among children with liver cirrhosis and portal hypertension (esophageal varices).Materials and Methods:We conducted an analytical cross-sectional study in Imam Hossein Children's Hospital, Isfahan, Iran, in 2016. A number of 33 cirrhotic children with or without esophageal varices were selected through convenience sampling method to be compared with 19 healthy children as controls using color and spectral Doppler US.Results:Portal vein mean velocities were 15.03 ± 7.3 cm/s in cirrhotics, 16.47 ± 6.4 cm/s in controls (P = 0.51), 11.6 ± 4.7 cm/s in patients with varices, and 17.9 ± 7.3 cm/s in patients without varices (P = 0.015). Mean diameters of caudate lobe, portal vein, and splenic vein, as well as the mean values of liver and spleen span, were significantly higher in cirrhotic children. The frequency of flow reversal (hepatofugal flow) was not detected significantly different in cirrhotics. Peak systolic velocity, end diastolic velocity, pulsatility index, and resistive index for hepatic artery as well as liver vascular index were not significantly different in cirrhotics in comparison with controls.Conclusion:Alterations in Doppler parameters of portal vein including diameter and velocity may be the helpful indicators of liver cirrhosis and esophageal varices in children, respectively. Parameters of hepatic artery may not differentiate children with liver cirrhosis.

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“…The most commonly used metric to determine prognosis for patients with cirrhosis is the MELDNa score. (2) However, at a given MELDNa score, the clinical manifestations of patients with end-stage liver disease are highly heterogeneous. (3) As such, a novel tool is needed to objectively capture this risk.…”

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confidence: 99%

A novel frailty index improves risk prediction of waitlist mortality over the model for end‐stage liver disease score alone

Fan

Zhu

2018

Hepatology

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Doppler Ultrasound in Liver Cirrhosis: Correlation of Hepatic Artery and Portal Vein Measurements With Model for End-Stage Liver Disease Score

Abstract: We found a statistically significant correlation with elevated HAv and increasing MELD scores, splenomegaly, and presence of ascites in patients with cirrhotic liver disease; this may be a useful imaging biomarker in the evaluation of patients with cirrhosis.

Cited by 20 publications

References 21 publications

Markedly elevated hepatic arterial velocity—HAV greater than 200 cm/s—is not specific to hepatobiliary disease

Markedly elevated hepatic arterial velocity—HAV greater than 200 cm/s—is not specific to hepatobiliary disease

Doppler assessment of children with liver cirrhosis and portal hypertension in comparison with a healthy control group: An analytical cross-sectional study

A novel frailty index improves risk prediction of waitlist mortality over the model for end‐stage liver disease score alone

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