Portal hemodynamics disorders severity scoring by Doppler ultrasound in liver cirrhosis

Abstract

Background: Splenoportal hemodynamics assessment in portal hypertension syndrome is a well-known problem, due to the high incidence of this pathology and associated complications. The accuracy of employed diagnostic methods is of paramount importance as early diagnosis and appropriate management can certainly improve the prognosis and life expectancy of these patients. The study aim was to identify reliable Doppler measurements for developing a scoring system of portal flow alteration severity in liver cirrhosis and classification of these disturbances. Material and methods: The study included 111 patients with liver cirrhosis. Ultrasound examinations were performed with a Voluson E8 ultrasound system, using a 3.5-5 MHz convex transducer. The examination included B mode, color Doppler and pulse-wave Doppler techniques. All patients also underwent extended clinical and biological evaluation. Obtained data were processed using case-based reasoning, data segmentation and clusterization. Results: A scoring system for severity of portal hemodynamics disorders in liver cirrhosis was developed based on five most relevant conventional and Doppler parameters. The scoring system allows classification of portal flow alterations as low, middle and high severity. Conclusions: The developed scoring system can be used as a useful complementary tool in differential diagnosis of portal flow alterations in liver cirrhosis. The proposed score also allows a better dynamic imaging follow-up of patients with liver cirrhosis.