Hepatic vein Doppler waveform changes in early stage (Child-Pugh A) chronic parenchymal liver disease.

Abstract

Doppler waveform changes can be found in chronic parenchymal liver disease, especially in the late stages. We investigated the contribution of Doppler ultrasound in diagnosing early-stage chronic parenchymal liver disease. In this prospective study, 30 patients who had been diagnosed with chronic liver disease (Child-Pugh class A) and 30 healthy subjects were studied. The diagnosis was confirmed with histopathologic examinations of biopsy specimens in 17 patients. The Doppler US examination of hepatic veins was performed in all the patients and healthy subjects. The Doppler US pattern was classified into three groups according to the Doppler signal characteristics: (1) type 0, triphasic waveform, the presence of a short phase of reversed flow, (2) type I, decreased amplitude of the phasic oscillations without the short phase of reversed flow, and (3) type II, complete flat waveform. Normal hepatic vein waveforms (type 0) were found in 8 patients (26.66%) and abnormal hepatic waveforms (type I + type II) in 22 patients (73.33%). The results of Doppler ultrasonography were correlated with the diagnosis of early-stage chronic parenchymal liver disease (Child-Pugh class A). In all the subjects of the control group, the Doppler waveform of hepatic veins showed the triphasic pattern (type 0). In the statistical evaluation using Fisher's exact test we observed that there was a significant difference (p < 0.05) between the control group and the patient group with respect to the presence of abnormal (type I + type II) Doppler waveform. The diagnostic accuracy in the patients who had biopsy was 76.47% and that in the patients who did not was 69.23%.