HEPATIC AND PORTAL-VEIN FLOW PATTERN IN CORRELATION WITH INTRAHEPATICFAT DEPOSITION AND LIVER HISTOLOGY IN PATIENTS WITH CHRONIC HEPATITIS-C

OBJECTIVE. The flow pattern in hepatic veins depends on cardiac physio logy and liver histology. The aim of our study was to determine the de pendence of the flow pattern of hepatic and portal veins in relation t o histologic features in patients with chronic hepatitis C. SUBJECTS A ND METHODS. In 135 patients with chronic hepatitis C, the Doppler sono graphy spectrum of the right hepatic vein was classified as triphasic, biphasic, or monophasic. The flow of the portal vein was characterize d according to the undulation (velocity(max-min)). A liver biopsy was performed during sonography, and biopsy specimens were semiquantitativ ely evaluated on a histologic activity index and a score of the hepati c fat content. Multiple logistic regression analysis was used to ident ify the histologic features that might contribute to the type of flow pattern. RESULTS. The hepatocyte fat content was the only variable ass ociated with an independent effect on the type of flow pattern (monoph asic versus triphasic; odds ratio, 16.26; 95% confidence interval, 6.3 8-41.45; p < .0001). A pronounced undulation in the portal vein was as sociated with portal inflammation but not with other parameters of the histologic activity index or the intrahepatic fat deposition. CONCLUS ION. On sonography, the normal flow pattern in the right hepatic vein is triphasic, The monophasic flow pattern in the right hepatic vein is mainly caused by intrahepatic fat deposition and occasionally by infl ammatory or fibrotic changes. Conversely, the flow pattern of the port al vein is mainly influenced by portal inflammation.