Changes in Doppler parameters of portal pressure after interventional management of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) has many options for management; some of them are complicated by development of portal hypertension (PHT). Doppler ultrasound is an effective method to diagnose and monitor PHT changes after HCC ablation procedures. The aim of this study is to investigate changes in po...

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Bibliographic Details
Published in:Abdominal imaging 2016-08, Vol.41 (8), p.1532-1538
Main Authors: El Sherbiny, Walid, AbdelRahman, Ashraf, Diasty, Muhammad, Shaltout, Shaker Wagih
Format: Article
Language:English
Subjects:
Ablation Techniques - methods
Adult
Carcinoma, Hepatocellular - surgery
Female
Gastroenterology
Hepatology
Humans
Hypertension, Portal - diagnosis
Hypertension, Portal - physiopathology
Imaging
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Portal Pressure - physiology
Prospective Studies
Radiology
Treatment Outcome
Ultrasonography, Doppler - methods
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Summary:Hepatocellular carcinoma (HCC) has many options for management; some of them are complicated by development of portal hypertension (PHT). Doppler ultrasound is an effective method to diagnose and monitor PHT changes after HCC ablation procedures. The aim of this study is to investigate changes in portal pressure hemodynamics of HCC patients following treatment with different interventional strategies: radiofrequency ablation (RFA), microwave ablation (MWA), and transarterial chemoembolization (TACE). A total of 60 patients with HCC were divided into three main groups, and each group received a different type of therapy (RFA, MWA, and TACE). Full medical record and basic investigations were performed including Doppler ultrasound and upper GIT endoscopy for evaluation of PHT parameters, and then repeated after three months of ablation. RFA is associated with the increased splenic artery resistive index, while MWA has no significant impact on PHT indices. TACE has led to a marked increase in liver vascular index with significant decrease in hepatic artery resistive index and PHI after treatment. No significant changes in esophageal varices were observed by upper GIT endoscopy following all ablation methods. RFA is quite safe but associated with degree of PHT. On the contrary, TACE is associated with improved PHT parameters. MWA has no significant association to development of PHT following the technique. Doppler ultrasound could be used as a reliable and effective method of evaluation of PHT post ablation for HCC.
ISSN:2366-004X
2366-0058
DOI:10.1007/s00261-016-0704-0