Mohan Sravya, Sakalecha Anil K, A Raveesha, Krishnan Jagannathan, S N Rashmi
Radiodiagnosis, Sri Devaraj Urs Medical College, Kolar, IND.
General Medicine, Sri Devaraj Urs Medical College, Kolar, IND.
Cureus. 2025 Aug 18;17(8):e90377. doi: 10.7759/cureus.90377. eCollection 2025 Aug.
Nonalcoholic fatty liver disease (NAFLD) causes progressive liver fibrosis and vascular remodeling. Portal vein pulsatility index (PVPI) has emerged as a potential ultrasound biomarker for high-risk NAFLD, but its relationship to other Doppler measures is not fully explored.
To evaluate PVPI as a noninvasive tool for staging NAFLD and to incorporate portal vein resistive index (RI) and peak systolic velocity (PSV) parameters for a more comprehensive assessment of hepatic vascular resistance.
We performed a case-control study of NAFLD patients (spanning mild steatosis to advanced fibrosis) and healthy controls. All subjects underwent duplex Doppler ultrasound. PVPI was calculated as [(Vmax - Vmin)/Vmean]. Simulated portal RI and PSV values for each NAFLD severity group were also derived. Key outcomes were compared across steatosis grades and fibrosis categories and correlated with fibrosis risk scores.
NAFLD patients had significantly lower PVPI than controls (p < 0.001), and PVPI decreased progressively with higher steatosis grade and fibrosis stage. High-risk NAFLD (significant fibrosis) showed a markedly reduced PVPI (mean ~0.20 vs. ~0.30 in low-risk) alongside a decline in portal RI and PSV. For example, portal PSV dropped from ~13 cm/s in mild NAFLD to ~10 cm/s in advanced fibrosis. PVPI correlated with fibrosis stage (r ~ -0.44), and adding RI/PSV helped delineate increases in hepatic vascular resistance.
Portal vein Doppler indices (PVPI, RI, PSV) worsen with NAFLD severity. PVPI, especially when complemented by RI and PSV, is a promising noninvasive marker for staging NAFLD and identifying high-fibrosis risk.
非酒精性脂肪性肝病（NAFLD）会导致进行性肝纤维化和血管重塑。门静脉搏动指数（PVPI）已成为高危NAFLD的一种潜在超声生物标志物，但其与其他多普勒测量指标的关系尚未得到充分探索。
评估PVPI作为NAFLD分期的非侵入性工具，并纳入门静脉阻力指数（RI）和收缩期峰值流速（PSV）参数，以更全面地评估肝血管阻力。
我们对NAFLD患者（涵盖轻度脂肪变性至晚期纤维化）和健康对照进行了一项病例对照研究。所有受试者均接受了双功多普勒超声检查。PVPI计算为[（Vmax - Vmin）/Vmean]。还得出了每个NAFLD严重程度组的模拟门静脉RI和PSV值。对不同脂肪变性等级和纤维化类别之间的关键结果进行了比较，并与纤维化风险评分相关联。
NAFLD患者的PVPI显著低于对照组（p < 0.001），并且PVPI随着脂肪变性等级和纤维化阶段的升高而逐渐降低。高危NAFLD（显著纤维化）显示PVPI明显降低（平均约0.20，而低风险组约为0.30），同时门静脉RI和PSV下降。例如，门静脉PSV从轻度NAFLD时的约13 cm/s降至晚期纤维化时的约10 cm/s。PVPI与纤维化阶段相关（r约为 -0.44），并且添加RI/PSV有助于描绘肝血管阻力的增加。
门静脉多普勒指标（PVPI、RI、PSV）随NAFLD严重程度加重而恶化。PVPI，尤其是在辅以RI和PSV时，是一种有前景的用于NAFLD分期和识别高纤维化风险的非侵入性标志物。
