Doppler assessment of children with liver cirrhosis and portal hypertension in comparison with a healthy control group: An analytical cross?sectional study
Abstract
Background: Doppler ultrasonography (Doppler US) plays an important role in evaluating patients with liver cirrhosis. Tis study aims to investigate the hemodynamic alterations of hepatic artery and portal vein among children with liver cirrhosis and portal hypertension (esophageal varices). Methods: We conducted an analytical cross?sectional study in Imam Hossein Children’s Hospital, Isfahan, Iran, in 2016. A number of 33 cirrhotic children with or without esophageal varices were selected through convenience sampling method to be compared with 19 healthy children as controls using color and spectral Doppler US. Results: Portal vein
mean velocities were 15.03 ± 7.3 cm/s in cirrhotics, 16.47 ± 6.4 cm/s in controls (P = 0.51), 11.6 ± 4.7 cm/s in patients with varices, and 17.9 ± 7.3 cm/s in patients without varices (P = 0.015). Mean diameters of caudate lobe, portal vein, and splenic vein, as well as the mean values of liver and spleen span, were signifcantly higher in cirrhotic children. Te frequency of ?ow reversal (hepatofugal ?ow) was not detected signifcantly di?erent in cirrhotics. Peak systolic velocity, end diastolic velocity, pulsatility index, and resistive index for hepatic artery as well as liver vascular index were not signifcantly di?erent in cirrhotics in comparison with controls.
Conclusions: Alterations in Doppler parameters of portal vein including diameter and velocity may be the helpful indicators of liver cirrhosis and esophageal varices in children, respectively. Parameters of hepatic artery may not di?erentiate children with liver cirrhosis.
mean velocities were 15.03 ± 7.3 cm/s in cirrhotics, 16.47 ± 6.4 cm/s in controls (P = 0.51), 11.6 ± 4.7 cm/s in patients with varices, and 17.9 ± 7.3 cm/s in patients without varices (P = 0.015). Mean diameters of caudate lobe, portal vein, and splenic vein, as well as the mean values of liver and spleen span, were signifcantly higher in cirrhotic children. Te frequency of ?ow reversal (hepatofugal ?ow) was not detected signifcantly di?erent in cirrhotics. Peak systolic velocity, end diastolic velocity, pulsatility index, and resistive index for hepatic artery as well as liver vascular index were not signifcantly di?erent in cirrhotics in comparison with controls.
Conclusions: Alterations in Doppler parameters of portal vein including diameter and velocity may be the helpful indicators of liver cirrhosis and esophageal varices in children, respectively. Parameters of hepatic artery may not di?erentiate children with liver cirrhosis.
Keywords
Cirrhosis, Doppler ultrasonography, pediatrics, portal hypertension, portal vein