Correlation of MRI liver volume and Doppler sonographic portal hemodynamics with histologic findings in patients with chronic hepatitis C

Purpose. The purpose of this study was to correlate portal hemodynamics on sonography and liver volume on MRI with histologic findings in asymptomatic patients with chronic hepatitis C. Methods. Portal blood flow in the left and right portal branches in 20 heal thy volunteers and in 26 patients was measured using Doppler sonography dur ing both fasting and postprandial states. Total liver and right- and left-l obe volumes were determined using MRI. The ratio between portal blood flow and liver volume determined the "portal flow index" of the right and left l obes. Results. We observed a statistically significant difference (p < 0.01) betw een the volunteers and patients in the mean left-robe volume (352 +/- 81 cm (3) versus 544 +/- 159 cm(3)) and in the mean left portal flow index (1.1 /- 0.2 ml/minute/cm(3) versus 0.69 +/- 0.2 ml/minute/cm3) as measured befor e the subjects ate. After a meal, the portal blood-flow volume in the right robe was similar in the 2 groups but in the left robe was significantly lo wer in the patients (p = 0.0009). The left postprandial portal flow index w as inversely correlated with the grade of liver fibrosis (r = 0.533). Conclusions. The left-lobe volume (positive predictive value, 83%; negative predictive value, 72%) and left postprandial portal flow index (positive p redictive value, 86%; negative predictive value, 88%) are sensitive indicat ors of chronic hepatitis. The left postprandial portal flow index may be a useful test for differentiating patients with minimal or no fibrosis from p atients with mild to severe fibrosis. (C) 2000 John Wiley & Sons, Inc.