Value of splanchnic Doppler ultrasound in the diagnosis of portal hypertension

The accuracy of various Doppler parameters of portal circulation in the dia gnosis of relevant portal hypertension (presence of gastroesophageal varice s) was prospectively validated. The following parameters were compared in 5 1 patients with chronic liver disease (40 with cirrhosis and 11 with chroni c hepatitis): portal vein flow velocity and congestion index, hepatic and s plenic arteries resistance indexes (RI), modified liver vascular index (por tal flow velocity/hepatic artery RI) and portal hypertension index, a new i ndex calculated as: [(hepatic artery RI x 0.69) x (splenic artery RI x 0.87 )]/portal vein flow velocity. Highest accuracy was achieved by the splenic artery RI and the portal hypertension index (both around 75%) at cut-offs, respectively, of 0.60 and 12 cm/s(-1), which appeared to be, therefore, the most favorable parameters for the clinical practice. Their use may limit t he need for endoscopy to search for varices.