M. Ohta et al., PROGNOSTIC-SIGNIFICANCE OF HEPATIC VEIN WAVE-FORM BY DOPPLER ULTRASONOGRAPHY IN CIRRHOTIC-PATIENTS WITH PORTAL-HYPERTENSION, The American journal of gastroenterology, 90(10), 1995, pp. 1853-1857
We prospectively evaluated the prognostic value of the flat hepatic ve
in waveform, measured by Doppler ultrasound, in cirrhotic patients wit
h portal hypertension. Methods: The Doppler pattern of right and left
hepatic veins in a series of 120 consecutive cirrhotic patients with p
ortal hypertension but without hepatocellular carcinoma was examined,
together with clinical and biochemical parameters. Results: Flat wavef
orm of the right hepatic vein was recognized in nine patients and that
of the left hepatic vein was seen in 13. After a mean follow-up of 13
.6 +/- 9.7 months, 17 patients died, all from liver failure. In the un
ivariate analysis, variables significantly associated with the duratio
n of survival were age, etiology of the liver cirrhosis, upper gastroi
ntestinal bleeding after start of the study, Child-Pugh score, ascites
, encephalopathy, prothrombin index, bilirubin; albumin, and flat Dopp
ler waveform in the right and left hepatic veins. Multivariate analysi
s showed that flat Doppler waveform in the right hepatic vein, bilirub
in, and prothrombin index were independently related to survival. Conc
lusions: The prognostic accuracy in cases of cirrhosis with portal hyp
ertension is significantly improved with acquistion of information obt
ained from hepatic vein waveform by Doppler ultrasound.