Duplex Doppler Ultrasound of the Hepatic Artery in Patients With Acute Alcoholic Hepatitis

Abstract

In the appropriate clinical setting, an elevated hepatic artery diameter or PSV measurement is suggestive of AAH. Duplex Doppler ultrasound offers a noninvasive test to assist in the diagnosis of AAH.

“Pseudotumoral” hepatic pattern in acute alcoholic hepatitis: A case report

“…This unusual finding was first www.wjgnet.com described in two reports [9,10] , possibly involving the same single case. More recently, Colli et al [12] described both the CT and histological characteristics of "pseudotumoral" hepatic areas in five patients with AAH.…”

“…An additional interesting finding, in the present case, was the presence of a typical alcohol-related duplexDoppler image, called "pseudoparallel channel sign", reported in patients with AAH by Sumino et al [7] and characterized by dilated intrahepatic arterial branch with an adjacent portal venous tract. A dilation of hepatic artery, with increased peak systolic velocity, has also been described by Han et al [9] , who assumed that in AAH the presence of liver fibrosis increases sinusoidal resistance, blocking sinusoidal blood flow and ultimately portal blood flow in a retrograde manner. Therefore, in order to maintain hepatic perfusion, there is a dilation of hepatic artery leading to increased blood flow.…”

“…Colli et al [8] reported a statistically significant decrease of hepatic artery RI in patients with AAH, as compared to both healthy and cirrhotic patients, a finding in contrast with the cirrhotic pattern observed in our patient. The possible relevance of the hepatic artery RI in AAH has also been challenged by Han et al [9] , who reported a high variability of this sign in patients with liver disease, accounting for a lack of a clear-cut distinction between AAH and cirrhosis.…”

“…On US liver scan, the presence of "pseudoparallel channel signs" and of low hepatic artery resistivity index (RI) at duplex Doppler investigation have both been reported in AAH [7][8][9] . A "pseudotumoral" hepatic pattern at CT scan has also been reported in this setting, even if only scanty data are available [10] .…”

A study concerning morphometry of abdominal aorta branches and abdominal viscera: relations and correlation

“…Detailed common hepatic artery morphometry knowledge is necessary for generation of flow models, critical for chemoembolisation procedures and microspheres design [5]. Common hepatic artery diameter increases in some diseases like cirrhosis and alcoholic hepatitis [34].…”