Portal Venous Pulsatility Index: A Novel Biomarker for Diagnosis of High-Risk NonAlcoholic Fatty Liver Dise

Abstract

Objective: To assess the accuracy of portal vein pulsatility (VPI) for non-invasive diagnosis of high-risk non-alcoholic fatty liver disease (NAFLD).
 Study Design: Cross-sectional study.
 Place and Duration of Study: Pakistan Institute of Medical Science, Islamabad Pakistan, from Jan to May 2022.
 Methodology: Duplex Doppler ultrasound was used to examine the main portal vein in patients with a biopsy-proven Nonalcoholic fatty liver disease (NAFLD) diagnosis. Patients were evaluated by Doppler ultrasonography after fasting for four hours in accordance with standard methodology. The maximum (Vmax) and minimum (Vmin) blood velocities in the portal veins were measured using the spectral waveform. 
 Results: Out of 240 NAFLD patients, 102(42.50%) were males, and 138(57.50 %) were females. According to the Non-alcoholic Steatohepatitis clinical research network (NASH CRN) scoring system, 95(39.58%) patients had F0 disease, 80(33.33%) had F1, 30(12.5%) patients F2, 24(10%) patients had F3 and 11(4.58%) had F4. 50(53.76%) patients in the low-risk group and 43(46.24%) patients in the high-risk group had diabetes. Of 102 males, 73(71.56%) had low risk, and 29(28.44%) had high risk. While out of 138 females, 79(57.24%) females had low risk, and 59(42.76%) females had a high risk of NAFLD. Venous pulsatility index, NAFLD fibrosis score, FIB-4, BARD score, and APRL had statistically significant differences (p<0.05).
 Conclusion: Venous pulsatility index is a reliable marker for detecting high-risk NAFLD. It is a readily available non-invasive investigation and can be reliably used as a screening tool for detecting NAFLD in high-risk patients, avoiding invasive investigation.