RELATIONSHIP BETWEEN PORTAL BLOOD-FLOW MEASURED BY IMAGE-DIRECTED DOPPLER ULTRASONOGRAPHY AND HEPATIC BLOOD-FLOW MEASURED BY INDOCYANINE GREEN CONSTANT INFUSION IN PATIENTS WITH CIRRHOSIS

The validity of portal blood flow measurement in image-directed Droppl er ultrasound (PBF-IDU) is still under debate. In this study PBF-IDU h as been compared with hepatic blood flow measured by the indocyanine g reen constant infusion technique (HBF-ICG), which is the reference inv asive method with which to measure total hepatic blood flow in man tie , the sum of hepatic artery and portal vein blood flow). In 27 cirrhot ic patients with hepatopetal portal blood flow, PBF-IDU was measured b y multiplying the portal vein cross-sectional area by the averaged mea n velocity of blood in the vessel. About 1 hour later HBF-ICG was meas ured during hepatic vein catheterization performed to evaluate portal hypertension. In 19 of 27 patients, intrahepatic arterial resistance i ndices were also measured. PBF-IDU and HBF-ICG were 1.010 +/- 0.555 L/ min (M +/- SD) and 1.496 +/- 0.731 L/min, respectively. Blood flow mea sured by the two methods showed a close correlation (r = 0.80, p < 0.0 01). The regression line showed that HBF-ICG was systematically higher than PBF-IDU (mean difference +29 +/- 30%). The hepatic artery compon ent of HBF-ICG probably accounted for the difference. An inverse corre lation was found between the differences between the two procedures an d intrahepatic arterial resistance indices (r = -0.52, p = 0.04), whic h may be considered indirect parameters of arterial supply. It can be concluded that image-directed Doppler ultrasound is a sufficiently acc urate method to measure portal blood flow in cirrhotics. (C) 1995 John Wiley and Sons, Inc.