Latheef Sumaiya, Patil Shivanand, Sajjan Siddaroodha, Kolekar Pavan
Radiodiagnosis, Shri BM Patil Medical College Hospital and Research Centre, Bijapur Lingayat District Educational Association (BLDE) (Deemed to be University), Vijayapura, IND.
Cureus. 2025 May 7;17(5):e83658. doi: 10.7759/cureus.83658. eCollection 2025 May.
Background Liver cirrhosis is the terminal stage of chronic liver disease, marked by progressive fibrosis and vascular remodeling that alters hepatic hemodynamics. Doppler ultrasonography enables non-invasive assessment of these changes by analyzing hepatic vein waveform patterns. This study aimed to evaluate the correlation between hepatic vein waveform alterations and cirrhosis severity, as classified by the Child-Pugh score, and to assess the diagnostic performance of waveform analysis in clinical staging. Methodology In this prospective, observational study, 140 patients with clinically or radiologically confirmed cirrhosis underwent Doppler ultrasonography of hepatic veins. Waveform patterns were categorized as triphasic, biphasic, or monophasic and correlated with Child-Pugh classification and other demographic and laboratory parameters. Statistical analyses assessed the strength of these associations and the diagnostic accuracy of waveform classification. Results The cohort included 59.3% males and 40.7% females, with 45% aged 41-60 years. According to Child-Pugh classification, 22.9% of patients were Class A, 25% were Class B, and 52.1% were Class C. Hepatic vein waveforms were monophasic in 38.6%, biphasic in 36.4%, and triphasic in 25% of patients. A statistically significant association was observed between waveform patterns and disease severity (p < 0.001), with 70.4% of monophasic and 68.6% of biphasic waveforms seen in Class C patients, and 57.1% of triphasic waveforms in Class A patients. Waveform changes also correlated significantly with age (p = 0.008). Diagnostic evaluation revealed 100% sensitivity and negative predictive value, along with 52.2% specificity and 69.5% positive predictive value for predicting advanced cirrhosis. Conclusions Hepatic vein waveform analysis via Doppler ultrasonography is a reliable, non-invasive indicator of cirrhosis severity, demonstrating a strong correlation with the Child-Pugh classification. Its high sensitivity and negative predictive value support its utility as a screening tool for advanced disease. Integrating waveform assessment into routine ultrasound protocols offers valuable prognostic insight without additional cost or complexity.
背景 肝硬化是慢性肝病的终末期，其特征为进行性纤维化和血管重塑，从而改变肝脏血流动力学。多普勒超声检查通过分析肝静脉波形模式能够对这些变化进行无创评估。本研究旨在评估肝静脉波形改变与根据Child-Pugh评分分类的肝硬化严重程度之间的相关性，并评估波形分析在临床分期中的诊断性能。方法 在这项前瞻性观察性研究中，140例临床或影像学确诊的肝硬化患者接受了肝静脉多普勒超声检查。波形模式分为三相、双相或单相，并与Child-Pugh分类以及其他人口统计学和实验室参数相关联。统计分析评估了这些关联的强度以及波形分类的诊断准确性。结果 该队列中男性占59.3%，女性占40.7%，45%的患者年龄在41至60岁之间。根据Child-Pugh分类，22.9%的患者为A类，25%为B类，52.1%为C类。38.6%的患者肝静脉波形为单相，36.4%为双相，25%为三相。在波形模式与疾病严重程度之间观察到统计学上的显著关联（p < 0.001），C类患者中70.4%的波形为单相，68.6%为双相，A类患者中57.1%的波形为三相。波形变化也与年龄显著相关（p = 0.008）。诊断评估显示，对于预测晚期肝硬化，敏感性和阴性预测值均为100%，特异性为52.2%，阳性预测值为69.5%。结论 通过多普勒超声检查进行肝静脉波形分析是肝硬化严重程度的可靠无创指标，与Child-Pugh分类显示出很强的相关性。其高敏感性和阴性预测值支持其作为晚期疾病筛查工具的效用。将波形评估纳入常规超声检查方案可提供有价值的预后见解，而无需额外成本或复杂性。
