A sonographic doppler study of hepatic vein, portal vein and hepatic artery in liver cirrhosis: correlation of hepatic haemodynamics and liver dysfunction

Abstract

s / Clinical Radiology 67 (2012) S1–S10 S10 Results: We present a comprehensive pictorial review of the features of PAPVD across several imaging modalities, including tips for the general radiologist. We also describe the congenital associations which, if present, should prompt a search for PAPVD. Knowledge of the above is important particularly in the diagnostically challenging patient or where precise anatomicalmappingof thepulmonaryveins is requiredprior to intervention. Conclusion: The radiologist plays an important role in diagnosing PAPVD. A knowledge of the imaging features will lead to prompt diagnosis and facilitate pre-procedural planning, contributing to a favourable patient outcome. The CT features of chronic thromboembolic pulmonary hypertension (CTEPH) Authors: Shalini Wijesuriya, Ladli Chandratreya Purpose: Chronic occlusion of pulmonary arteries by emboli can lead to a progressive elevation of pulmonary artery pressures with sequelae such as chronic thromboembolic pulmonary artery hypertension (CTEPH) and right ventricular dysfunction. Diagnosis and early recognition of CTEPH is crucial as it is potentially curablewith pulmonary thromboendarterectomy and if left untreated, is associatedwith significant morbidity andmortality. Unfortunately, patients may go undetected for years and diagnosis is made challenging by the non-specific nature of the clinical presentation. CTEPH is being increasingly recognised and as the radiologist may be the first individual to make a diagnosis of CTEPH, knowledge of the conventional and less common CT features is crucial. Methods and materials: A pictorial review of cases of chronic thromboembolic pulmonary hypertension based on experiences at our institution. Results: We present a comprehensive pictorial review of the vascular, cardiac and pulmonary parenchymal CT features of chronic thromboembolic pulmonary hypertension. Furthermore, we discuss potential pitfalls and help distinguish CTEPH from other common mimics such as acute embolism and idiopathic pulmonary hypertension. Conclusion: We hope that highlighting the key diagnostic features in CTEPH will improve confidence, notably amongst trainees, leading to fewer diagnostic delays and an improvement in overall patient outcome. A sonographic doppler study of hepatic vein, portal vein and hepatic artery in liver cirrhosis: correlation of hepatic haemodynamics and liver dysfunction Authors: Richard H. Lo, Azizah Mohamed Afif, Yanyan Wang, Denise Lau, Chin C. Ooi Purpose: To evaluate parameters involved in haemodynamics of liver vasculature in patients with cirrhosis and in normal healthy volunteers using Doppler Ultrasound. Methods and Materials: A study sample of 32 patients with Child-Pugh A (n1⁄425), B (n1⁄45), and C (n1⁄42) liver cirrhosis was compared with a control group of 26 normal health screening participants. Right hepatic vein (RHV), right portal vein (RPV) and main hepatic artery were interrogated. Results: All patients in control group showed normal triphasic waveform in RHV. In the study group, RHV blunted waveform was detected in 3 patients in Child-Pugh A, 1 in B and all patients in C category. Waveform alteration was independent of Child-Pugh score. Hepatic Artery Resistive Index (HARI) was significantly higher in study group than in control group (p<0.001). Maximum Portal Vein Velocity (MPVV) also was significantly lower in study group than in control group (p1⁄40.02). Mean Maximum Hepatic Vein Velocity (MHVV) and Maximum Hepatic Artery Velocity (MHAV) did not show significant difference between the 2 groups, with p1⁄40.16 and p1⁄40.38 respectively. Conclusion: Altered waveform of hepatic veins is suggestive of changes within a cirrhotic liver. HARI and MPVV can be useful parameters to assess liver cirrhosis. Doppler Ultrasound is a good non-invasive assessment tool for evaluating the haemodynamics of liver cirrhosis.