The prediction of liver disease status using Doppler observations of the hepatic and portal venous system compared with liver biopsy in patients with chronic hepatitis C

Abstract

The prediction of liver disease status using Doppler observations of the hepatic and portal venous system compared with liver biopsy in patients with chronic hepatitis C Ashraf Anas Zytoon,1 Abdel Naser A Gad Allah,2 Ahmed Faisal3 1Radiology Department, Faculty of Medicine, 2Gastroenterology Unit, Internal Medicine Department, Menoufia University, Menoufia, Egypt; 3Infectious and Endemic Diseases Unit, Internal Medicine Department, Suez Canal University, Ismailiya, Egypt Objective: To investigate the influence of chronic hepatitis C-induced hepatic tissue damage on hepatic dopplerographic hemodynamics. Subjects and methods: A total of 118 patients with chronic hepatitis C underwent both liver biopsy and ultrasound with duplex dopplerography of right hepatic and portal veins. A liver biopsy was performed during sonography, and biopsy specimens were evaluated. Hepatic and portal vein flow pattern was correlated with the total modified histologic activity index (HAI), fibrosis score, and intrahepatic fat content. Hepatic vein Doppler curve was evaluated. The flow of the portal vein was characterized according to the velocity undulation. Multiple logistic regression analysis was used to identify the best histological features that might contribute to hepatic hemodynamic alterations. Results: The Doppler sonography spectrum of the right hepatic vein was classified as triphasic in 27 (23%), biphasic in 67 (57%), and monophasic in 24 (20%) patients. A significant difference was observed in the HAI, fibrosis score, and hepatosteatosis between patients with triphasic, biphasic, and monophasic flow patterns in the right hepatic vein (P<0.001). Portal vein waveform was flattened in patients with chronic hepatitis C (Vmax–min index =3.6±2.4). Multiple logistic regression analysis was used to evaluate the histologic features that contributed to the hepatic and portal vein flow-pattern changes. The HAI was the best correlated independent variable. Conclusion: The alterations in dopplerographic hemodynamics of hepatic and portal veins have a strong correlation with hepatitis C virus-induced inflammatory and fibrotic changes as well as hepatosteatosis. Keywords: liver, hepatitis C, hepatic vein, portal vein, histologic activity index (HAI), Doppler