The role of Doppler Velocity Histograms of hepatic veins in early detection of cirrhotic changes of the liver parenchyma

Aim: In a prospective study we measured the velocity ranges of the Doppler Velocity Histogram (DVH) of the hepatic venous system at two levels (- 3 dB and - 6 dB) below the maximum power level of the Doppler wave in order to investigate if that allows a higher selectivity between the Doppler tracing s in hepatic veins of patients with liver cirrhosis and healthy subjects. M ethods: The DVH was measured in 23 healthy subjects and 31 patients with li ver cirrhosis of different etiologies at power levels of - 3 and - 6dB in t he right and middle hepatic vein after an overnight fast. The DVH measureme nts were performed at the maximum of phase I of the hepatic venous flow in which we assessed the Peak-, Mode-, Mean-Value, and the velocity range (ban dwidth). Results: At both power levels the bandwidth (BW) of the DVH in the right and middle hepatic vein was significantly higher in cirrhotics than in healthy subjects (-3 dB: RHV: p = 0.048, MHV: p = 0.006; -6 dB: RHV and MHV: p<0.0005). The selectivity between healthy subjects and cirrhotics is higher at the - 6 dB level than at the - 3 dB level. Conclusion: The DVH-me asurement is a useful additional device in early sonographic detection of c irrhotic liver parenchyma changes. DVH-velocity range measurements at a lev el of - 6 dB below the maximum power level reveal a better selectivity betw een healthy subjects and cirrhotic patients than measurements at the -3dB l evel. It is recommendable to perform velocity range measurements at differe nt power levels within a single frozen image.