Splenic Doppler impedance indices: Influence of different portal hemodynamic conditions

• DOI: 10.1002/hep.510230515
• Publication Date: 2004-11-11T23:47:24Z
• Authors: M Bolognesi; D Sacerdoti; C Merkel; G Gerunda; A Maffei-Faccioli; P Angeli; R M Jemmolo; G Bombonato; A Gatta
• Keywords: Portal vein thrombosis; Splenic vein

The spleen plays a pivotal role in the pathogenesis and maintenance of portal hypertension. Few data exist about splenic hemodynamics evaluated by duplex sonography this condition. Twenty-six normal subjects, 207 patients with hypertension various causes, different splenoportal hemodynamic conditions, 31 liver transplantation were evaluated. In each patient resistive index (RI = peak systolic--end diastolic velocity/peak systolic velocity) pulsatility (PI velocity/mean measured. 17 cirrhotic patients, indices compared as invasively hepatic vein catheterization. groups, RI PI respectively: 0.51 +/- 0.05 0.72 0.11; hepatopetal blood flow (n 167), 0.64 0.08 1.03 0.24; hepatofugal 3), 0.74 1.27 0.08; thrombosis 9), 1.36 0.34; noncirrhotic obstruction system 7), 0.69 0.11 1.16 0.28; surgical decompression 21), 0.54 0.07 0.76 0.15; 31), 0.50 0.70 0.15. Both significantly higher controls (P < .0001), even .004 P .001 comparison values patients). thrombosis, impedance than those .0001). Cirrhotic who underwent surgery for therapy showed decreased other transplantation, same controls. 23 52 surgically treated (surgical shunt or transplantation), both before after treatment. All these decrease PI, .0001) large esophageal varices without small .02 .01). not related to age, mean arterial pressure, sex, Child-Turcotte-Pugh score, presence ascites, cause. A significant correlation was found between resistance catheterization (r .80, values; r .87, values). conclusion, study shows that are increased seems demonstrate cirrhosis reflect resistance.