Association between duplex Doppler sonographic flow pattern in right hepatic vein and various liver diseases

Purpose. The aim of this study was to evaluate the association between the Doppler sonographic waveforms in the right hepatic vein and various liver d iseases. Methods. We performed Doppler sonography of the right hepatic vein in 225 i ndividuals (189 patients with liver disease and 36 control subjects). Patie nts were categorized on the basis of their histologic diagnosis: cirrhosis (n = 122), fibrosis (n = 23), fatty liver disease In = 11), metastatic live r disease (n = 8), and noncirrhotic liver disease with neither fatty infilt ration nor metastases (n = 25). The waveforms of the hepatic veins were cat egorized as type 1, triphasic; type 2, biphasic; or type 3, flat. Results. Type 1 waveforms were found in 100% of the control subjects and in patients with each of the various liver diseases, including 40% of those w ith cirrhosis. Type 2 waveforms were not found in control subjects or in pa tients with either fatty infiltration or metastatic liver disease. Type 2 w aveforms were, however, found in 16% of patients with cirrhosis, 13% of pat ients with fibrosis, and 4% of patients with other noncirrhotic liver disea ses. Type 3 waveforms were found in 43% of patients with liver cirrhosis, 1 3% of patients with liver fibrosis, 27% of patients with fatty liver diseas e, and 50% of patients with metastatic liver disease. In contrast, type 3 w aveforms were not found in any control subjects or in patients with other n oncirrhotic liver diseases without fatty liver or metastases. Conclusions. Type 3 waveforms in the right hepatic vein are suggestive of l iver cirrhosis, although they may also occur in patients with fibrosis, fat ty liver disease, or metastatic liver disease. (C) 2000 John Wiley & Sons, Inc.