Effects of fat accumulation in the liver on hemodynamic variables assessed by doppler ultrasonography

• Published in: Journal of clinical ultrasound 2015-01, Vol.43 (1), p.26-33
• Main Authors: Topal, Naile Bolca, Orcan, Serap, Sığırlı, Deniz, Orcan, Gökhan, Eritmen, Ülkü
• Format: Article
• Language: English
• Subjects: Blood Flow Velocity; Doppler US; Fatty Liver - diagnostic imaging; Female; Hemodynamics; hepatic artery; Hepatic Artery - diagnostic imaging; hepatic vein; Hepatic Veins - diagnostic imaging; hepatosteatosis; Humans; Liver - diagnostic imaging; Male; Middle Aged; portal vein; Portal Vein - diagnostic imaging; Prospective Studies; Ultrasonic imaging; Ultrasonography, Doppler - methods
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.22157

ABSTRACT Purpose To investigate the effect of various degrees of fatty liver infiltration on hepatic hemodynamics using Doppler ultrasonography. Methods We included 40 patients with hepatic steatosis and 20 healthy volunteers. Hepatic steatosis was quantified by a chemical shift MRI. Hepatic artery peak systolic and end‐diastolic velocity, resistance index (RI) and pulsatility index (PI), hepatic vein RI and PI, portal vein RI, PI, congestion index, and peak maximum velocity were evaluated by Doppler ultrasonography. The hepatic vein waveforms were classified as triphasic, biphasic, or monophasic. Kruskal‐Wallis test was performed for comparing more than two groups. If significant differences were found, Mann‐Whitney U test with Bonferroni correction was performed for pair‐wise comparisons. Pearson 2 and Fisher's exact tests were used to compare categorical variables. Results According to MRI, 15 patients had mild, 14 patients had moderate, and 11 patients had severe fatty infiltration. Portal vein peak maximum velocity was median: 19.8 (range 12–33.3), 21.1 (8–41.8), 16.6 (10.6–24.9), and 29.2 (14.1–40.4) cm/s. Congestion index was 0.05 (0.02–0.16), 0.07 (0.01–0.17), 0.11 (0.06–0.24), and 0.05 (0.02–0.16). Hepatic artery RI was 0.75 (0.56–1.00), 0.66 (0.52–0.87), 0.83 (0.38–1.00), and 0.76 (0.48–2.76), and PI was 1.83 (0.90–3.13), 1.38 (1.04–2.63), 1.97 (0.86–2.90), and 1.82 (0.70–2.90) (p = .046 and p = .036) in the mild, moderate, severe steatosis, and control groups, respectively. The rate of triphasic hepatic vein waveforms was higher in controls than in patients with severe steatosis. Conclusions Portal vein flow velocity decreases in severe hepatic steatosis when compared with controls. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43:26–33, 2015