INTEROBSERVER AND INTEREQUIPMENT VARIABILITY OF HEPATIC, SPLENIC, ANDRENAL ARTERIAL DOPPLER RESISTANCE INDEXES IN NORMAL SUBJECTS AND PATIENTS WITH CIRRHOSIS

Background/Aims: Doppler arterial resistance indices are used to evalu ate alterations in arterial hemodynamics in the liver, spleen, and kid ney The purpose of this study was to determine the interobserver and i nterequipment variability of hepatic, splenic. and renal arterial Dopp ler resistance indices, and the influence of a cooperative training pr ogram of the operators on the reproducibility of the results. Methods: In the first part of the study, hepatic (PI-L, RI-L), splenic (PI-S, RI-S), and renal (PI-K, RI-R) pulsatility and resistive indices were m easured by echo-color-Doppler in eight control subjects and ten patien ts with cirrhosis by three operators using three different machines, I n the second part of the study measurements mere taken by the three op erators in nine controls and nine patients with cirrhosis, after coope rative training, with a single machine. Results: Significant interobse rver variability was present for all parameters except RI-L, Significa nt interequipment variability was present for all parameters except PI -S and RI-S, Only 0-3% of variance was equipment-or operator-related, while 58-72% was patient-related. Hepatic and renal coefficients of va riation were similar in patients,vith cirrhosis and controls, while sp lenic coefficients of variation Here higher in patients with cirrhosis than in controls, After training, differences among operators disappe ared for all variables except RI-K, and the operator-related component of variance nearly disappeared for all parameters. Conclusions: Hepat ic, splenic, and renal arterial resistance indices show Small but sign ificant interobserver and interequipment variability. Interobserver va riability can be decreased to non-significant levels by a common train ing program, Thus, these indices can be widely applied to the study of arterial circulation in these organs.