OBJECTIVES:This prospective study was designed to assess the sensitivity and specificity of Doppler ultrasound parameters in the diagnosis of cirrhosis and portal hypertension. METHODS:Portal and hepatic arterial Doppler ultrasound was performed on 76 patients with cirrhosis and esophageal varices and on 73 age- and sex-matched controls. The parameters evaluated were portal venous velocity and hepatic arterial pulsatility index. The liver vascular index was calculated as the ratio of portal venous velocity to hepatic arterial pulsatility index. RESULTS:Portal venous velocity was significantly lower (11.0 +/- 2.4 vs 15.9 +/- 2.8 cm/s, p < 0.001) and hepatic arterial pulsatility index was significantly higher (1.28 +/- 0.18 vs 0.95 +/- 0.17,p < 0.001) in patients than in controls. Thus, the liver vascular index was significantly lower in patients than in controls (8.7 +/- 2.1 vs 17.2 +/- 4.3 cm/s, p < 0.001). The sensitivity and specificity of these parameters in the detection of cirrhosis and portal hypertension was then analyzed with the receiver operating characteristic curve. The best cut-off values were considered to be 13 cm/se of portal venous velocity and 1.1 of hepatic arterial pulsatility index, showing a sensitivity and specificity of 83, 85, 84, and 81%, respectively. The best cut-off value of the liver vascular index was 12 cm/s with a sensitivity and specificity of 97 and 93%, respectively. CONCLUSIONS:The liver vascular index is a high sensitive and specific Doppler ultrasound parameter in the diagnosis of cirrhosis and portal hypertension.

译文

目的:本前瞻性研究旨在评估多普勒超声参数在肝硬化和门静脉高压症诊断中的敏感性和特异性。
方法:对76例肝硬化和食管静脉曲张患者以及73例年龄和性别匹配的对照者进行门静脉和肝动脉多普勒超声检查。评价的参数是门静脉速度和肝动脉搏动指数。肝血管指数计算为门静脉速度与肝动脉搏动指数之比。
结果:门静脉血流速度显着降低(11.0 /-2.4 vs 15.9 /-2.8 cm / s,p <0.001),肝动脉搏动指数显着升高(1.28 /-0.18 vs 0.95 /-0.17,p <0.001)患者比对照组。因此,患者的肝血管指数显着低于对照组(8.7 /-2.1对17.2 /-4.3 cm / s,p <0.001)。然后使用接收器工作特性曲线分析这些参数在检测肝硬化和门脉高压中的敏感性和特异性。最佳临界值被认为是门静脉速度的13 cm / se和肝动脉搏动指数的1.1,分别显示出83%,85%,84%和81%的敏感性和特异性。肝血管指数的最佳临界值为12 cm / s,敏感性和特异性分别为97%和93%。
结论:肝血管指数是诊断肝硬化和门静脉高压症的高敏感度和特异性多普勒超声参数。

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