Onwuka Chidiogo Chukwunweike, Famurewa Olusola Comfort, Adekanle Olusegun, Ayoola Oluwagbemiga Oluwole, Adegbehingbe Olugbenga Olumide
Department of Radiology, ABUAD Multi System Hospital, Ado-Ekiti, Nigeria.
Department of Radiology, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
J Med Ultrasound. 2022 May 3;30(2):109-115. doi: 10.4103/JMU.JMU_91_21. eCollection 2022 Apr-Jun.
This study assessed the hepatic vein waveform (HVW) and mean maximum portal vein velocity (MM-PVV) on Doppler ultrasound in patients with liver cirrhosis (LC) and compared it with that of age and sex-matched controls. It correlated the degree of HVW abnormality and MM-PVV changes with liver function based on Child-Turcotte-Pugh (CTP) to determine which was more predictive of CTP.
Sixty patients with LC and 60 healthy controls were consecutively recruited into this study. Each patient was classed based on the CTP system after relevant tests. Doppler evaluation of the hepatic vein (HV) and MM-PVV were performed. HVW obtained was classified either into triphasic, biphasic, or monophasic.
Sixty cirrhotic and 60 age-matched control subjects aged 19-69 and 18-69 years, respectively, completed this study. All control subjects had a normal HVW pattern while 46 (76.7%) cirrhotic subjects had abnormal HVW ( < 0.001). The MM-PVV was significantly lower in cirrhotic subjects than in controls; 22.8 cm/s versus 33.6 cm/s ( < 0.001). The degree of HVW abnormality among cirrhotics showed a significant positive correlation with CTP ( = 0.283, = 0.029). MM-PVV on the other hand showed no correlation with CTP class ( = -0.124; = 0.346). Linear regression showed that HVW was a significant predictor of hepatic dysfunction based on CTP.
Changes in the waveform pattern of the HVs are a good predictor of the derangement of hepatic function in patients with LC than changes in PVV. HVW pattern could therefore serve as an adjunct to CTP class in hepatic function assessment.
本研究评估了肝硬化（LC）患者肝脏静脉波形（HVW）和门静脉平均最大流速（MM-PVV）的多普勒超声表现，并与年龄和性别匹配的对照组进行比较。基于Child-Turcotte-Pugh（CTP）分级，将HVW异常程度和MM-PVV变化与肝功能进行关联，以确定哪项指标对CTP分级更具预测性。
本研究连续纳入60例LC患者和60例健康对照。每位患者在进行相关检查后根据CTP系统进行分级。对肝静脉（HV）进行多普勒评估并测量MM-PVV。获得的HVW分为三相波、双相波或单相波。
分别有60例年龄在19 - 69岁的肝硬化患者和60例年龄在18 - 69岁的年龄匹配对照完成了本研究。所有对照对象的HVW模式均正常，而46例（76.7%）肝硬化患者的HVW异常（P < 0.001）。肝硬化患者的MM-PVV显著低于对照组；分别为22.8 cm/s和33.6 cm/s（P < 0.001）。肝硬化患者中HVW异常程度与CTP分级呈显著正相关（r = 0.283，P = 0.029）。另一方面，MM-PVV与CTP分级无关（r = -0.124；P = 0.346）。线性回归显示，基于CTP分级，HVW是肝功能障碍的显著预测指标。
与门静脉流速变化相比，肝静脉波形模式的改变是LC患者肝功能紊乱的更好预测指标。因此，HVW模式可作为CTP分级在肝功能评估中的辅助指标。
