Portal and Hepatic Artery Hemodynamics in Cirrhotic Patiens: Relationship with the Severity of Portal Hypertension and Hepatic Failure

The aim of our study was to investigate the value of Doppler ultrasonography of the portal vein and hepatic artery in liver cirrhosis and to detect any relationship between the ultrasonographic changes and the severity of the portal hypertension and hepatic failure.
Methods: The study comprised 112 patients diagnosed with cirrhosis who had different degrees of esophageal varices, no ascites and who had been divided into groups according to Child-Pugh score. We evaluated the portal vein and hepatic artery velocities and we calculated the hepatic artery resistance and pulsatility index.
Results: Our data suggest that in patients with cirrhosis there is a significant correlation between the pulsatility index and the size of esophageal varices (p < 0.0001) and between the portal velocity and the size of esophageal varices (p < 0.0001). We found a significant inverse correlation between the portal velocity and the pulsatility index (r = -0.63) and a negative correlation between the portal velocity and the resistance index (r = -0.23).There was no correlation between the portal velocity and the peak systolic arterial flow (r = 0.017). There were no statistical differences of the studied portal vein and hepatic artery hemodinamics to different stages of liver
disease.
Conclusion: Portal vein and hepatic artery hemodinamics are unrelated to the degree of hepatic failure. In patients with cirrhosis the hepatic artery pulsatility index is correlated with the severity of the portal hypertension respectively with the degree of esophageal varices. Doppler ultrasound determination of these indices may contribute to a non-invasive evaluation of varices.