Hepatic and portal vein flow pattern in correlation with intrahepatic fat deposition and liver histology in patients with chronic hepatitis C.

Abstract

OBJECTIVE.The flow pattern in hepatic veins depends on cardiac physiology and liver histology. The aim of our study was to determine the dependence of the flow pattern of he patic and portal veins in relation to histologic features in patients with chronic hepatitis C. SUBJECTS AND METHODS.In 135 patients with chronic hepatitis C, the Doppler sonography spectrum of the right hepatic vein was classified as triphasic, biphasic, or monophasic. The flow of theportalvein wascharacterizedaccordingto theundulation(veloc itYm@min). A liver biopsy was performed during sonography, and biopsy specimens were semiquantitatively evaluatedon a histologicactivity index anda scoreof the hepaticfat con tent. Multiple logistic regression analysis was used to identify the histologic features that might contribute to the type of flow pattern. RESULTS.The hepatocyte fat content was the only variable associated with an indepen dent effect on the type of flow pattern (monophasic versus triphasic; odds ratio, 16.26; 95% confidence interval, 6.38â€"41.45; p < .0001). A pronounced undulation in the portal vein was associated with portal inflammation but not with other parameters of the histologic activity in dex or the intrahepatic fat deposition. The normal triphasic Doppler sonography waveformof hepaticveinsvanesaccordingto changes in the central venous pressure. During atrial and ventricular diastole, two portions of the signal (phase I and phase II) reflect the hepatofugalflow to the heart, while during atrial contraction a third portion (phase ifi) representsa short interval of reversedflow [1,10]. Conflicting data have been reported concerning changes of the flow pattern in rela tion to chronic liver disease. A few studiessug gested that liver fibrosis or cirrhosis and transplant rejection may reduce undulation of the hepatic flow pattern [2][3][4]7]. The possible contribution of inflammatory changes and mtra hepaticfat depositionhasneverbeensystemati cally investigated.To address thesequestions, chronichepatitis C is an attractiveclinical model [11â€"13] be causethe diseasecan causethe completehisto logic spectrum of inflammatory and fibrotic changes[14â€"17] andcan lead to variable intra hepaticfat deposition [3,18]. In the present study, we examined 135 patients with chronic hepatitis C and 75 age-and sex-matched healthy subjectsusing B-mode and duplex

Portal Vein Hemodynamics in Patients with Non-Alcoholic Fatty Liver Disease

“…The relative contributions of intrahepatic fat deposition and inflammatory changes to the flow patterns of the hepatic and portal veins are unknown (Dietrich et al 1998). The main finding of this study is that the VPI, MFV, V max , and V min decrease in patients with fatty liver.…”

“…Previous studies have shown that the flow of the hepatic and portal veins is altered in patients with liver cirrhosis, portal vein thrombosis, Budd-Chiari syndrome, and vascular malformations (Dietrich et al 1998;Bargallo et al 2006;Bolognesi et al 2007). However, a recent study with a similar design has been published showing the relationship between fatty infiltration of the liver and decreased portal venous velocity and pulsatility (Balci et al 2008).…”

“…In normal adults, the VPI is 0.48 (Gallix et al 1997). Dietrich et al (1998) BMI, body mass index; VPI, pulsatility; MFV, flow velocity; V max , peak maximum velocity; V min , peak minimum velocity. gated the correlation between the V max , V min , and V max -V min of the portal vein and the degree of fatty infiltration defined histologically in biopsyproven hepatitis-C patients, and found that V max , V min , and V max -V min decreased as the degree of hepatosteatosis increased.…”

Nonalcoholic fatty liver disease: a challenge for pediatricians

“…86 Table 3 presents results of the imaging techniques used in diagnosis of NAFLD-NASH. 86,[90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109] The underlying physical principle of imaging techniques are the same between adults and children. Consequently research in both age groups could be used to approve the use of these methods in pediatric field.…”

“…91 The hepatic and portal vein flow pattern is correlated with fatty infiltration, and occasionally with inflammation and fibrosis. 13,92,93 US of the liver is a safe and repeatable imaging technique. It should be part of the routine health examination of obese adolescents.…”