Doppler waveforms of the hepatic veins in children with diffuse fatty infiltration of the liver

Uzun, Hakan; Yazıcı, Burhan; Erdoğmuş, Beşir; Kocabay, Kenan; Büyükkaya, Ramazan; Büyükkaya, Ayla; Yazgan, Ömer

doi:10.1016/j.ejrad.2008.06.004

Cited by 19 publications

(22 citation statements)

References 14 publications

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“…Abnormal Doppler waveform was detected in two third of FL patients identified by B-mode US. Uzun et al made a similar study and detected abnormal HV Doppler waveform in almost all obese children with diffuse fatty infiltration of the liver diagnosed by B-mode US [32]. In our study, we did compare the two different ultrasonographic methods for their capability to diagnose FLD, because the liver biopsies could not be performed.…”

Section: Discussionsupporting

confidence: 45%

“…Waveform classification (i.e., biphasic or monophasic) depended on the presence or absence of phasic oscillation, which was defined as a regular change in wave amplitude in cadence with the cardiac cycle. A monophasic waveform was defined as complete loss of the normal phasic oscillation (i.e., completely flat or with fluttering defined as low-amplitude oscillations, without any variation in amplitude) [32].…”

Section: Hv Doppler Usmentioning

confidence: 99%

“…There is only one previous study which used hepatic vein (HV) Doppler US used to evaluate hepatic steatosis in children and adolescents, however, metabolic parameters were not evaluated [32]. The aims of our study were: (1) to determine the frequency of asymptomatic FLD in overweight and obese adolescents using both Doppler and Bmode US; (2) to investigate the possible differences related to the degree of obesity, insulin resistance, lipid profile, and serum adiponectin levels identifying FLD of overweight and obese adolescents by two different methods; and (3) to evaluate metabolic predictors of FL shown by these methods.…”

Section: Introductionmentioning

confidence: 98%

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Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

et al. 2010

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(1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents aged between 9.0 and 17.0 years and 41 non-obese healthy adolescents were included in this study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and adiponectin levels were evaluated in all adolescents. HDL-C levels were significantly lower in patients with FL detected by Doppler US compared to patients without FL (p < 0.05). HDL-C levels were inversely correlated with presence of FL assessed by two methods (r = -0.285, p = 0.004; r = -0.328, p = 0.001, respectively) and adiponectin levels were correlated with presence of FL only detected by B-mode US (r = -0.263, p = 0.008). Adiponectin levels were significantly lower in patients with FL than those without FL assessed by B-Mode US (p = 0.049). Multiple regression analysis revealed that HDL-C levels was the most important predictor of FL assessed by Doppler US (p = 0.027), while body mass index was the determinant of FL assessed by two methods (p < 0.001) in asymptomatic overweight and obese adolescents. It was found that FLD, identified by both B-mode and Doppler US, is seen frequently in asymptomatic overweight and obese adolescents. Elevated BMI is associated with increased risk of FL assessed by two ultrasonographic methods. When using Doppler US, low HDL-C levels can be used as a good predictor for presence of FLD in overweight and obese adolescents.

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Section: Discussionsupporting

confidence: 45%

Section: Hv Doppler Usmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

et al. 2010

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“…Reduced hepatic blood flow is observed in experimental animals with fatty deposition in the liver, and similar data are expected in humans [4]. Recent articles suggest that NAFLD can change the waveform pattern of hepatic veins [7][8][9] and portal vein doppler indices [10][11]. NAFLD can also decrease hepatic artery resistance index [12].…”

Section: Introductionmentioning

confidence: 74%

Comparison of Portal Vein Doppler Indices and Hepatic Vein Doppler Waveform in Patients with Nonalcoholic Fatty Liver Disease with Healthy Control

et al. 2011

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BackgroundThe purpose of the present study is to investigate the association of nonalcoholic fatty liver disease (NAFLD) with the doppler waveform pattern of hepatic veins and portal vein doppler indices.ObjectivesThis assay may be useful in evaluating the natural course of NAFLD and monitor treatment efficacy on follow-up.Patients and MethodsThis case control study was performed in 31 patients with NAFLD and 31 normal healthy adults who served as the control group. The patients presented with elevated liver enzymes levels (ALT/AST) and hyperechogenic livers in the B-mode ultrasonography examination. Eleven patients had a liver biopsy. After an 8-hour fast,B-mode and duplex doppler ultrasonography were performed, and the waveform patterns of the right hepatic vein, portal vein diameter, grade of fatty liver, portal vein pulsatility index (VPI), and mean flow velocity (MFV) were measured.ResultsVPI and MFV values were 0.42 ± 0.92 and 17.27 ± 5.34 cm/second, respectively, in the control group and 0.25 ± 0.50 and 12.82 ± 4.32 cm/second in patients with NAFLD (P< 0.01). The frequency of abnormal hepatic vein doppler waveform patterns (biphasic or monophasic) was significantly higher in patients with NAFLD (55.2%) versus control subjects (3.2%) (P < 0.001). There was no correlation between the degree of fat infiltration and VPI (P = 0.714), MFV (P = 0.911), or hepatic vein waveform pattern (P = 0.197). We found no correlation between liver enzyme levels and MFV or VPI. However, the rate of abnormal hepatic vein was higher in patients with enzyme levels that exceeded twice the normal value (P = 0.05).ConclusionsPatients with NAFLD have a high rate of abnormal hepatic vein doppler waveform patterns, and decreased VPI and MFV are suggestive of reduced vascular compliance in the liver. Elevated liver enzymes levels do not influence VPI or MFV, but patients with abnormal enzymes have higher rates of abnormal hepatic vein doppler waveform patterns.

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“…In spite of being evaluated since 1983 [2] ; the accuracy, sensitivity and specificity of duplex Doppler imaging as a non-invasive diagnostic and prognostic modality for liver cirrhosis, and its correlation to the histopathologic findings as well as the degree of functional impairment of the liver, remains controversial and is still debated by many investigators [3] . Adding duplex Doppler evaluation in numerous studies has clarified the role of this modality in the evaluation of various CLD in adults and children, including liver cirrhosis [4][5][6][7] ; portal hypertension [8][9][10][11][12] ; presence or absence of esophageal varices [13] , noninvasive diagnosis of the degree of hepatic fibrosis [14,15] , assessment of the portal venous blood flow in cystic fibrosis [16] , perioperative monitoring in orthotropic liver transplantation (LTx) [17] , prediction of the severity of veno-occlusive disease and assessing its prognosis [18] , assessment of the functional hepatic flow and total hepatic flow [19] and investigating the effect of fatty infiltration of the liver on the Doppler waveform pattern in the hepatic veins of obese children [3,20] . Other studies evaluated Doppler US measurement of the blood flow in the hepatic artery, hepatic veins and portal vein as a noninvasive indicator of disease severity in children who had undergone Kasai portoenterostomy for extrahepatic biliary atresia [21] and those who had CLD of unknown etiology [22] .…”

Section: Introductionmentioning

confidence: 99%

Value of duplex doppler ultrasonography in non-invasive assessment of children with chronic liver disease

El-Shabrawi

Sheiba²,

El‐Karaksy³

et al. 2010

WJG

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Doppler waveforms of the hepatic veins in children with diffuse fatty infiltration of the liver

Cited by 19 publications

References 14 publications

Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

Comparison of Portal Vein Doppler Indices and Hepatic Vein Doppler Waveform in Patients with Nonalcoholic Fatty Liver Disease with Healthy Control

Value of duplex doppler ultrasonography in non-invasive assessment of children with chronic liver disease

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