VALUE OF THE MEASUREMENT OF PORTAL FLOW VELOCITY IN THE DIFFERENTIAL-DIAGNOSIS OF ASYMPTOMATIC SPLENOMEGALY

Aim and Methods: This prospective study was carried on 20 patients (10 with liver cirrhosis and 10 with myelo-lymphoproliferative disorders! , consecutively admitted to our ward for splenomegaly and thrombocytop enia, with the aim of evaluating the ability of Duplex-Doppler ultraso nography (DDUS) to discriminate between congestive splenomegaly and en larged spleen caused by haematological disorders. Results: Comparing t he clinical/laboratory and DDUS findings for the two groups, it emerge d that maximum-portal flow velocity (PFV) values revealed the most sta tistically significant differences: 17.31 SD 2.48 vs. 28.27 SD 3.53 (c m/s, P < 0.001), Discriminant analysis showed that max-PFV is the vari able which by itself maximizes the separation between the two groups ( F = 71.56; P < 0.0001), The patients with congestive splenomegaly exhi bited lower max-PFV than the controls (17.31 SD 2.48 vs. 26.29 SD 2.38 cm/s, P < 0.001), unlike those with haematological diseases, whose max -PFV values were greater, albeit not significantly so (28.27 SD 3.53 v s, 26.29 SD 2.38 cm/s, P = 0.161). Conclusions: DDUS assessment of por tal haemodynamics thus proved useful in the differential diagnosis of splenomegaly in asymptomatic patients since it distinguishes rapidly a nd non-invasively between congestive and haemotological splenomegaly. A lower-than-normal max-PFV value indicates congestive splenomegaly; a highish value, on the other hand, suggests a splenomegaly of haematol ogical origin.