Hepatic arterial blood flow velocities: assessment by transcutaneous and intravascular Doppler sonography

Background/Aims: Doppler sonography has been used to assess hepatic arteria l perfusion in a number of published reports. However, adequate validation studies are available for neither the transcutaneous nor the intravascular Doppler approach. The aim of this comparative study was to assess hepatic a rterial perfusion with both methods. Methods: In 15 patients the right hepatic artery was examined with intravas cular and transcutaneous Doppler sonography after calibration of Doppler de vices in vitro with a thread model. The measurements were performed simulta neously in five and separately within 24 h in 10 patients. Results: In vitro, the correlations between the velocities of the thread an d the velocities as determined by intravascular (r=1.0, p<0.001) and transc utaneous Doppler sonography (r=1.0, p<0.001) were excellent. In vivo the be st correlation was found for systolic peak velocities (intravascular: 58.5/-18.1 cm/s, mean+/-standard deviation, transcutaneous: 58.2+/-25.2 cm/s, r =0.63, p=0.01). Although lower mean (intravascular: 26.5+/-7.7 cm/s, transc utaneous: 32.5+/-14.4 cm/s) and end-diastolic velocities (intravascular: 11 .5+/-4.0 cm/s, transcutaneous: 18.4+/-8.6 cm/s) were found with intravascul ar compared to transcutaneous Doppler sonography, significant correlations were demonstrable between results obtained by both methods (r=0.63, p=0.01 for mean and r=0.57, p=0.025 for diastolic velocities). Similarly, the calc ulated resistive (intravascular: 0.79+/-0.07, transcutaneous: 0.68+/-0.06, r=0.65, p=0.009) and pulsatility indices (intravascular: 1.78+/-0.47, trans cutaneous: 1.26+/-0.25, r=0.55, p=0.034) were somewhat higher using the int ravascular device, but correlated well with the numbers obtained by the tra nscutaneous approach. Conclusions: The data suggest that with use of different Doppler devices, s ystolic velocities are the most suitable parameter for Doppler assessment o f hepatic arterial perfusion.