Duplex ultrasonography in evaluation of complications of portal hypertension in liver cirrhosis

Abstract

Background: Portal hypertension is a serious complication in liver cirrhosis and it is responsible for most of the deaths at patients with the respective disease. Determination of the pressure gradient by the catheterisation of hepatic veins is a laborious method and often associated with complications. There are necessary accessible methods to evaluate portal hypertension with an acceptable degree of confidence. This study aims to determine Doppler hemodynamic indicators with important predictable goal in case of complications of the portal hypertension associated with liver cirrhosis. Material and methods: The study group included 111 patients diagnosed clinicaly, biologicaly and imagining with liver cirrhosis. The cytolytic, cholestatic, hepatoprive syndromes and the gravity of hypersplenism were evaluated. Esophageal varices were identified by upper endoscopy. The hepatic morphology, including the personalisation of the vascular tree, was evaluated by conventional and duplex ultrasonography. Results: The increase of the vascular resistance at the level of lienal artery (r = 0.454), and the Splenoportal Index had an important correlation with the severity of the Splenomegalic Syndrome (r = 0.516). The prediction of the esophageal varices with high risk for haemorrhage was set at the value of 7-10 cm/sec of the time-weighted average velocity measured in the hepatic portal vein (RP 3.13). Ascites and portal thrombosis were more frequent at an index of the portal hypertension of (IHTP) >2.1 (RP 3.5). Conclusions: Evaluation of the hemodynamic indicators by duplex ultrasonography allowed to highlight the predictive parameters in case of complications of the portal hypertension associated with liver cirrhosis.