Comparison of Doppler ultrasonography and the hepatic venous pressure gradient in assessing portal hypertension in liver cirrhosis
Article first published online: 23 SEP 2008
Journal of Gastroenterology and Hepatology
Volume 18, Issue 4, pages 424–429, April 2003
How to Cite
CHOI, Y. J., BAIK, S. K., PARK, D. H., KIM, M. Y., KIM, H. S., LEE, D. K., KWON, S. O., KIM, Y. J. and PARK, J. W. (2003), Comparison of Doppler ultrasonography and the hepatic venous pressure gradient in assessing portal hypertension in liver cirrhosis. Journal of Gastroenterology and Hepatology, 18: 424–429. doi: 10.1046/j.1440-1746.2003.02992.x
- Issue published online: 23 SEP 2008
- Article first published online: 23 SEP 2008
- Accepted for publication 31 October 2002.
- Doppler ultrasonography;
- hepatic venous pressure gradient;
- liver cirrhosis;
- portal hypertension
Background and Aim: This prospective study aimed to determine whether Doppler ultrasonography can represent the hepatic venous pressure gradient (HVPG) as an assessment of the severity of portal hypertension and the response to terlipressin, which reduces the portal pressure in liver cirrhosis.
Methods: The HVPG and the Doppler ultrasonographic parameters, such as the portal venous velocity and the splenic venous velocity, the pulsatility and the resistive index of the hepatic, splenic and renal arteries were measured in 138 patients with liver cirrhosis. The changes in the HVPG and the portal venous velocity after administering terlipressin were evaluated in 43 of the 138 patients. The patients who showed a reduction in the HVPG of more than 20% of the baseline were defined as responders to terlipressin.
Results: None of the Doppler ultrasonographic parameters correlated with the HVPG. Both the HVPG (28.0 ± 19.8%) and the portal venous velocity (29.7 ± 13.2%) showed a significant reduction after terlipressin administration. However, the portal venous velocity decreased significantly, not only in the responders (31.0 ± 12.0%) but also in the non-responders (25.2 ± 16.4%).
Conclusions: Doppler ultrasonography does not represent the HVPG, and is therefore not suitable for replacing HVPG as a means of assessing the severity of portal hypertension and the response to drugs which reduce the portal pressure in liver cirrhosis.
© 2003 Blackwell Publishing Asia Pty Ltd