Abstract
Introduction. There are limited studies on simultaneous evaluation of liver and renal blood flow using Doppler methods. We evaluated and compared the changes of liver and renal Doppler US parameters in patients with liver cirrhosis according to the degree of liver disease. Material and Methods. We assessed a large spectrum of liver and renal Doppler US parameters in 67 patients with liver cirrhosis. Results. Significant differences between Child's classes or score, as well as MELD score, were observed in all investigated intrarenal blood flow Doppler US parameters, except renal artery peak systolic velocity, but only in some of the hepatic ones. The deviations of renal Doppler US parameters were also related with the complications of liver cirrhosis, as well as serum urea and creatinine levels. There was relationship between Doppler US parameters of hepatic artery and the corresponding renal artery Doppler US parameters. The changes of Doppler US parameters were age independent. Conclusion. Our results show, renal Doppler US parameters correlate with the severity and complications of liver cirrhosis. Because of dynamic deviations of renal Doppler US parameters with advance of liver cirrhosis, we recommend Doppler US of renal artery as a part of follow up of these patients.
Highlights
There are limited studies on simultaneous evaluation of liver and renal blood flow using Doppler methods
We evaluated the following hepatic and intrarenal blood flow Doppler parameters: Portal vein (PV) peak systolic velocity (PV-PSV), portal venous time-averaged maximum velocity (PVV = PV-PSV × 0,57), hepatic artery (HA) maximum peak systolic velocity (HA-PSV), HA minimal end diastolic velocity (HAEDV), HA mean velocity (HA-MnV = HA-PSV × 0,62), HA resistance index (HA-RI = HA-PSV − HA-EDV/HA-PSV), HA pulsatility index (HA-PI = HA-PSV − HA-EDV/HAMnV), liver vascular index (LVI = PVV/HA-PI), modified liver vascular index, arterio/portal ratio (A/P = HA-PSV/PV-PSV), RA peak systolic velocity (RA-PSV), RA minimal end diastolic velocity (RA-EDV), RA mean velocity (RA-MnV), RA resistance index (RA-RI = RAPSV − RA-EDV/RA-PSV), and RA pulsatility index (RA-PI = RA-PSV − RA-EDV/RA-MnV)
On the other hand HA mean velocity, HA maximum peak systolic velocity, and arterio/portal ratio were higher in patients with MELD score more than 20 compared to the patients with MELD score less than 20 (Table 3)
Summary
There are limited studies on simultaneous evaluation of liver and renal blood flow using Doppler methods. We evaluated and compared the changes of liver and renal Doppler US parameters in patients with liver cirrhosis according to the degree of liver disease. The deviations of renal Doppler US parameters were related with the complications of liver cirrhosis, as well as serum urea and creatinine levels. Renal Doppler US parameters correlate with the severity and complications of liver cirrhosis. There are limited studies on simultaneous evaluation of liver and renal blood flow using Doppler methods in real time [21]. The aim of our study was to evaluate and compare the changes of liver and renal Doppler US parameters in patients with liver cirrhosis according to the degree of liver disease. We assess the relationship between these parameters and some surrogate markers of renal function
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