Elsevier

Clinical Radiology

Volume 57, Issue 8, August 2002, Pages 746-752
Clinical Radiology

Regular Article
Hepatic Venous Pressure Gradients Measured by Duplex Ultrasound

https://doi.org/10.1053/crad.2002.0951Get rights and content

Abstract

AIMS: The hepatic venous pressure gradient is a major prognostic factor in portal hypertension but its measurement is complex and requires invasive angiography. This study investigated the relationship between the hepatic venous pressure gradient and a number of Doppler measurements, including the arterial acceleration index. METHOD: We measured the hepatic venous pressure gradient in 50 fasting patients at hepatic venography. Immediately afterwards, a duplex sonographic examination of the liver was performed at which multiple measurements and indices of the venous and arterial hepatic vasculature were made. RESULTS: Hepatic arterial acceleration was correlated directly with the hepatic venous pressure gradient (r = 0.83, P < 0.0001) and with the Child–Pugh score (r = 0.63, P < 0.0001). An acceleration index cut-off value of 1 m.s−2 provided a positive predictive value of 95%, a sensitivity of 65% and a specificity of 95% for detecting patients with severe portal hypertension (hepatic venous pressure gradient > 12 mmHg). A correlation between the hepatic venous pressure gradient and the congestion index of the portal vein velocity (r = 0.45,P = 0.01) and portal vein velocity (r = 0.40,P = 0.044), was also noted. CONCLUSION: Measuring the hepatic arterial acceleration index may help in the non-invasive evaluation of portal hypertension. Tasu, J-P. etal. (2002). Clinical Radiology57, 746–752.

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    Author for correspondence and guarantor of study: J-P. Tasu, Service de Radiologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre cedex, France. Fax: (33) 1 45 21 32 09; E-mail: [email protected]

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