Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
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.
How to cite this article:
K. Usharani and T. Srinivas. Assessment of Portal Hypertension Using High‐Resolution Ultrasonography and Colour Doppler.
DOI: https://doi.org/10.36478/makrjms.2017.6.240.245
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2017.6.240.245