TY  - JOUR
T1  - Assessment of Portal Hypertension Using High‐Resolution Ultrasonography and Colour Doppler
AU - Usharani, K. AU - Srinivas, T. 
JO  - Research Journal of Medical Sciences
VL  - 11
IS  - 6
SP  - 240
EP  - 245
PY  - 2017
DA  - 2001/08/19
SN  - 1815-9346
DO  - makrjms.2017.6.240.245
UR  - https://makhillpublications.co/view-article.php?doi=makrjms.2017.6.240.245
KW  - Portal hypertension
KW  - ultrasonography
KW  - doppler ultrasonography
KW  - color
KW  - esophageal varices
KW  - hemodynamics
KW  - collateral circulation
AB  - Portal hypertension (PH) is a major complication of chronic liver disease,
leading to esophageal varices, ascites, and portosystemic collaterals.
High‐resolution ultrasonography (USG) with colour Doppler offers a
noninvasive method for evaluating splanchnic hemodynamics, but earlier
studies before 2015 were often limited by small samples and variable
methodology. This study aimed to systematically assess portal vein and
collateral Doppler parameters in PH and compare them with clinical and
endoscopic findings. A prospective cross‐sectional study was conducted
in the Department of Radiology, including 110 patients with suspected
portal hypertension. All underwent high‐resolution USG and colour
Doppler using standardized protocols. Parameters recorded were: portal
vein diameter, cross‐sectional area, mean velocity, congestion index, flow
direction, hepatic and splenic artery resistive indices (RI), hepatic venous
waveforms with damping index (DI), and collateral veins (left gastric,
short gastric, paraumbilical). Endoscopy and clinical findings were used
as reference standards. Data were analyzed with Student’s t‐test,
chi‐square test, Pearson correlation, and ROC curve analysis. Portal vein
diameter (14.6 ± 2.1 mm) was significantly larger in patients with varices
(p < 0.001). Mean velocity was lower in those with large varices (10.8 ±
3.1 cm/s vs. 13.4 ± 3.5 cm/s, p = 0.002). The congestion index was higher
in varices (0.118 ± 0.03 vs. 0.089 ± 0.02, p < 0.001). Hepatic artery RI (0.74
± 0.06) and splenic artery RI (0.66 ± 0.05) correlated with ascites and
splenomegaly (p = 0.004, p = 0.001). Monophasic hepatic venous
waveforms and higher DI (0.67 ± 0.08) were associated with severe PH (p
< 0.001). LGV was the most frequent collateral (58.2%), with hepatofugal
flow in 95%. ROC analysis showed best diagnostic performance for LGV
diameter =6 mm (AUC 0.87, Se 88%, Sp 78%), congestion index =0.105
(AUC 0.84), and DI =0.66 (AUC 0.82). High‐resolution ultrasonography
with colour Doppler provides a reliable, noninvasive profile of portal
hypertension. LGV diameter, congestion index, and damping index
demonstrated the strongest diagnostic accuracy for predicting
esophageal varices. Our findings are concordant with earlier studies and
support a multiparametric Doppler protocol to stratify risk and guide
endoscopic surveillance in patients with PH.
ER  -