PROGNOSTIC-SIGNIFICANCE OF HEPATIC VEIN WAVE-FORM BY DOPPLER ULTRASONOGRAPHY IN CIRRHOTIC-PATIENTS WITH PORTAL-HYPERTENSION

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.