Hepatic vein spectral doppler waveform in patients with fatty liver changes – a study from Western Nepal
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Abstract
Background
Spectral Doppler waveform interpretation of hepatic vein is of considerable importance as it mirrors cardiac and hepatic physiology. The aim of this study was to evaluate the flow velocity waveform pattern in patients with different grades of fatty infiltration of liver and compare them with normal individuals.
Methods
This was a prospective study carried out in 213 patients, taking 100 patients as “control” groups; and 113 “cases” with varying degree of fatty liver graded by ultrasonography. The patients included asymptomatic individuals with no history of cardiac, hepatic disease or alcohol intake. The study also excluded cases with any medical disease such as ascitis that could influence the outcome of hepatic Doppler measurement. The Doppler hepatic waveform of the right hepatic vein was taken and classified as triphasic, biphasic and monophasic.
Results
All except one of the control group had normal triphasic pattern. Patients with severe grade of hepatic steatosis (Grade III) showed monophasic flow in 72.2% of the cases with sensitivity and specificity amounting to 83.3 and 87.7 respectively. A significant difference was observed in distribution of Doppler waveform pattern (p= 0.00001).
Conclusion
Triphasic waveform pattern was seen in majority of normal individuals with no cardiac or hepatic disease, while, in patients with increasing grade of hepatic steatosis, the waveform changed to biphasic and monophasic pattern due to decreased compliance of the hepatic veins.
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References
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