A COMPARISON OF DOPPLER FLOWMETRY WITH CONVENTIONAL ASSESSMENT OF ACUTE CHANGES IN HEPATIC BLOOD-FLOW

The validity and clinical relevance of Doppler flowmetry in measuring changes in regional blood flow are uncertain. In the present study we compared changes induced by ketanserin in regional splanchnic blood fl ow as measured by Doppler flowmetry with changes in conventionally mea sured systemic and in hepatic haemodynamic indices estimated pharmacok inetically using indocyanine green. Fourteen patients with alcoholic c irrhosis and portal hypertension were evaluated. On multivariate analy ses, significant associations were noted for only three indices: chang es in estimated hepatic blood flow were predicted jointly by changes i n flow in the main and right portal veins and hepatic artery (R(2) = 0 .80); changes in intrahepatic shunting (indocyanine green extraction) were predicted by changes in flow in the main and right portal veins ( R(2) = 0.55); and changes in sinusoidal perfusion (indocyanine green c learance) were significantly predicted by changes in main portal vein flow alone (R(2) = 0.76). These data support the validity of Doppler f lowmetry in quantifying change in regional blood flow, but highlight t he limitations in its clinical application and interpretation. The ass ociation of changes in main portal vein flow with changes in sinusoida l perfusion has clinical potential but requires confirmation using oth er modulating drugs.