ABNORMALITIES OF DOPPLER WAVE-FORM OF THE HEPATIC VEINS IN PATIENTS WITH CHRONIC LIVER-DISEASE - CORRELATION WITH HISTOLOGIC-FINDINGS

OBJECTIVE. Changes in the Doppler waveform of the hepatic veins are as sociated with chronic liver disease, particularly cirrhosis. We correl ated abnormalities in Doppler waveforms of hepatic veins with histolog ic findings in the liver to determine the accuracy of Doppler imaging in the detection of cirrhosis. SUBJECTS AND METHODS. Fifty-two patient s with chronic hepatitis C were examined prospectively and blindly by two sonographers. In the same session, a liver biopsy specimen was obt ained from each patient and submitted to three independent pathologist s for conventional interpretation and for grading of severity accordin g to a predetermined scoring system. Duplex sonography of the hepatic veins was also performed in 50 control subjects. RESULTS. Abnormal hep atic vein waveforms were detected in 12 of 16 patients with cirrhosis and in eight of 36 patients without cirrhosis. However, histologic exa mination of the biopsy specimens showed that only two of the eight pat ients without cirrhosis had no significant abnormalities, other than m ild portal inflammation. Abnormal waveforms were seen in no control su bjects. We found a correlation between fibrosis and steatosis and abno rmalities in the Doppler waveform of the hepatic veins (r = .50, p < . 001). Portal inflammation, intralobular degeneration, and necrosis did not correlate with an abnormal waveform. CONCLUSION. Duplex sonograph y of the hepatic veins may be useful for studying liver disease associ ated with fibrosis and steatosis. In patients with well-compensated li ver disease, flattening of the Doppler waveform of the hepatic vein su ggests the presence of cirrhosis.