Duplex Doppler Ultrasonography in Portal Hypertension

Yang, Sien–Sing

doi:10.1016/s0929-6441(08)60028-4

Cited by 6 publications

(7 citation statements)

References 100 publications

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“…jaundice, ascites, muscle wasting, cutaneous spider angiomas, ecchymosis, palmar erythema and flapping tremors; etc ) or biochemical findings (decreased serum albumin, increased prothrombin time, increased serum bilirubin, etc) suggestive of portal hypertension were selected. After noting all relevant information like history, clinical findings, biochemical investigations, ultrasound was done using sector probe (2-5 Mhz) and where required linear probe (7)(8)(9)(10)(11)(12).…”

Section: E T H O D Smentioning

confidence: 99%

“…5 In patients with alcoholic cirrhosis, PV blood velocity and flow are correlated to the severity of portal hypertension and to the severity of liver failure. 11 A low flow velocity of <16 cm/sec in addition to a caliber increase in the MPV are diagnostic features of portal hypertension. 12 Decrease in portal flow velocity has been found to be significant by other authors also.…”

Section: Portal Vein Flow Velocitymentioning

confidence: 99%

“…1 The presence of a non-hepatopetal flow pattern implicates an increased risk of oesophageal varices bleeding. 11 In most cases of portal hypertension, the flow is still hepatopetal but spectral doppler may demonstrate loss of respiratory phasicity and more pronounced cardiac periodicity which can progress to an absence of end-diastolic flow, arterialized flow or bidirectional "to-and-fro" flow. Rarely, with increasing hepatic parenchymal scarring and fibrosis, the pathway of least resistance for the hepatic arterial inflow becomes the portal vein resulting in reversed portal vein flow Studies have demonstrated that it is possible for patients with portal hypertension to have hepatofugal flow on one day and normal hepatopetal flow on another.…”

Section: Direction Of Flow In Portal Veinmentioning

confidence: 99%

“…Cirrhotics with the lowest portal velocity have oesophageal and gastric varices. 11 Portosystemic collaterals form when the resistance to blood flow in the portal vessels exceeds the resistance to flow in the small communicating channels between the portal and systemic circulations. According to Nakshabandi et al, the three most commonly identified collaterals include gastroesophageal junction, paraumbilical vein, splenorenal and gastrorenal collaterals.…”

Section: Collateralsmentioning

confidence: 99%

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To Study the Role of Duplex Sonography in Cases of Portal Hypertension

Singh¹,

Gupta²

2019

jemds

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BACKGROUND New techniques like elastography and hepatic vein transit time (HVTT) for diagnosing portal hypertension are costly, invasive, time-consuming and not easily available. CT/MRI are now easily available modalities, but they cannot establish flow pattern in portal venous system. Ultrasound (grey scale and colour doppler) though widely available are still not accepted as a definite tool to establish early PHT. We wanted to determine the role of ultrasound (greyscale and colour Doppler) as a definitive modality to diagnose early PHT, thus preventing absolute liver damage by fibrosis. METHODS This is a prospective cross-sectional study undertaken in the Department of Radiodiagnosis, Government Medical College, Amritsar, between February 2018 to May 2018, conducted among 50 patients clinically diagnosed/suspected as PHT. All these patients were given a sonographic examination. Sonographic findings including colour Doppler of blood flow pattern were studied. In addition, clinical and biochemical findings were also correlated. Findings were tabulated, subjected to statistical analysis and inferences were drawn. RESULTS Our study found a good correlation with the assessment of spleen size (≥13 cms) showing a p-value of 0.003. p-value of ascites is 0.008 while diameter of portal vein (p-value 0.005) also show strong correlation. Splenic vein was found to be highly specific (77.4%) but not sensitive. Decrease in velocity of portal vein correlated significantly, more with portal hypertension, as compared to increase in splenic vein velocity. Various collaterals showed 100% sensitivity with p-values for coronary collaterals of 0.001 and paraumbilical collaterals to be of 0.000. CONCLUSIONS Colour Doppler is still the best modality of choice for diagnosing portal hypertension at very early stages. Doppler helps by diagnosing direction of flow as well as velocity of portal venous system. It can also help in evaluating collaterals and portosystemic shunts. Other information provided by pulsed Doppler includes detection of venoocclusive disease.

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Section: E T H O D Smentioning

confidence: 99%

Section: Portal Vein Flow Velocitymentioning

confidence: 99%

Section: Direction Of Flow In Portal Veinmentioning

confidence: 99%

Section: Collateralsmentioning

confidence: 99%

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To Study the Role of Duplex Sonography in Cases of Portal Hypertension

Singh¹,

Gupta²

2019

jemds

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“…Ultrasound imaging has been widely used for imaging the liver and gallbladder (Wu, 2008) and therefore is ideal for potential noninvasive hepatic pressure measurements. Duplex Doppler ultrasonography has been previously proposed for HVPG estimation (Yang, 2007; Zironi et al, 1992; Wu, 2008) and has shown a clear relationship between quantitative results and esophageal varices development (Bolondi and Gaiani, 1994). However, this method is not sufficiently accurate or reproducible between observers for implementation in clinical practice for HVPG quantification (Bolondi et al, 1991; Vries et al, 1991; Vizzutti et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Ultrasonic characterization of the nonlinear properties of canine livers by measuring shear wave speed and axial strain with increasing portal venous pressure

Rotemberg

Byram

Palmeri

et al. 2013

Journal of Biomechanics

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Elevated hepatic venous pressure is the primary source of complications in advancing liver disease. Ultrasound imaging is ideal for potential noninvasive hepatic pressure measurements as it is widely used for liver imaging. Specifically, ultrasound based stiffness measures may be useful for clinically monitoring pressure, but the mechanism by which liver stiffness increases with hepatic pressure has not been well characterized. This study is designed to elucidate the nonlinear properties of the liver during pressurization by measuring both hepatic shear wave speed (SWS) and strain with increasing pressure. Tissue deformation during hepatic pressurization was tracked in 8 canine livers using successively acquired 3-D B-mode volumes and compared with concurrently measured SWS. When portal venous pressure was increased from clinically normal (0–5 mmHg) to pressures representing highly diseased states at 20 mmHg, the liver was observed to expand with axial strain measures up to 10%. At the same time, SWS estimates were observed to increase from 1.5–2 m/s at 0–5 mmHg (baseline) to 3.25–3.5 m/s at 20 mmHg.

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Alcoholic Liver Disease: Clinical and Sonographic Features

Yang

2008

Journal of Medical Ultrasound

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Duplex Doppler Ultrasonography in Portal Hypertension

Cited by 6 publications

References 100 publications

To Study the Role of Duplex Sonography in Cases of Portal Hypertension

To Study the Role of Duplex Sonography in Cases of Portal Hypertension

Ultrasonic characterization of the nonlinear properties of canine livers by measuring shear wave speed and axial strain with increasing portal venous pressure

Alcoholic Liver Disease: Clinical and Sonographic Features

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