Ultrasonic Hepatic Venous Waveform Pattern and its Association with Disease Severity and Related Complications in Patients with Cirrhosis

Background: Advanced imaging modalities such as Color Doppler Ultrasound (CDUS) are widely used for the clinical evaluation of liver cirrhosis and port hypertension using assessment of ultrasonic hepatic venous waveform patterns. The present study aimed to assess the usefulness of CDUS in evaluating patients with cirrhosis and also for predicting portal hypertension and esophageal varices as important life threatening consequences of cirrhosis. Methods: This cross-sectional study was performed on 31 consecutive patients with cirrhosis. Ultrasonic hepatic venous waveform pattern were determined and categorized as monophasic, biphasic and triphasic. The Damping and Splenoportal indices were also measured. Results: There was no association of ultrasonic hepatic venous waveform pattern with cirrhosis-related complications including liver encephalopathy (p = 0.817), esophageal varices (p = 0.372), and ascites (p = 0.471). We showed also no association between hepatic venous waveform pattern and liver disease severity based on the Child's classification (p = 0.331). The mean of Damping index was similar in the patients with and without each cirrhosis-related complications including liver encephalopathy (p = 0.134), esophageal varices, and ascites. Similar findings were revealed between Splenoportal index and the presence or absence on each complication. We found no difference in the mean of two Damping and Splenoportal indices across the different categorizes of liver disease severity. Conclusion: The record of the monophasic and biphasic patterns is predictable in most patients with cirrhosis and in a small number of healthy subjects without cirrhotic disorders. Also, recording these patterns together with the increase in two Damping and Splenoportal indices does not predict the severity of cirrhosis or its complications