ABSTRACT
The aim was to study the pattern of hemodynamic changes in both portal vein [PV] and hepatic artery [HA] through the different stages of acute viral hepatitis in children and to determine any sonographic correlation with the prognosis. Color Doppler US were performed on 50 patients with acute viral hepatitis [AVH] for four consecutive weeks and compared the results with those obtained on 20 normal controls. The portal vein diameter and velocity showed no significant changes neither during different stages of acute hepatitis nor with the control group, while during the acute phase, the peak-systolic velocity [PSV] and end-diastolic velocity [EDV] of the hepatic artery were significantly higher than those in normal arteries [P<0.01]. During the recovery phase, these indices of the hepatic artery decreased significantly to the control levels [P<0.01]. The resistive index [RI] related to vascular resistance in the hepatic artery during the acute phase were significantly less than those in normal arteries [P<0.01], and they increased significantly to the control levels during the recovery phase [P<0.01]. Doppler sonography is useful for imaging hepatic hemodynamic changes in children with acute viral hepatitis. We found that significant changes occur only in hepatic artery while no changes occurred in the portal vein. Also measurements of hepatic arterial flow during acute phase may be reliable for determining the prognosis of patients with viral hepatitis where the increased hepatic arterial blood flow during the acute phase may provide a marker for earlier recovery from hepatitis-induced damage and may be considered as a good marker for the prognosis
Subject(s)
Humans , Male , Female , Ultrasonography, Doppler, Color , Child , Acute DiseaseABSTRACT
To study the pattern of hemodynamic changes in both portal vein [PV] and hepatic artery [HA] through the different stages of acute viral hepatitis in children and to determine any sonographic correlation with the prognosis or with other studied paprameters including clinical features and liver function tests, we performed color Doppler sonography [after full clinical examination and laboratory investigation] with point spectral analysis in 50 children suffered from acute viral hepatitis for four consequtive weeks and compared the results with those in 20 normal controls. The portal vein diameter and velocity showed no significant changes either during different stages of acute hepatitis or with the control group while during the acute phase, the peak-systolic [PSV] and end-diastolic [EDV] velocity of the hepatic artery were significantly larger than those in normal arteries [P < 0.01]. During the recovery phase, these indexes of the hepatic artery decreased significantly to the control levels [P < 0.01]. The resistive indexes [RI] related to vascular resistance in the hepatic artery during the acute phase were significantly less than those in normal arteries [P < 0.01], and they increased significantly to the control levels during the recovery phase [P < 0.01]. No significant correlation was found between these indexes of the hepatic artery and the parameters of liver function tests. However, the interval between the acute phase and the recovery phase did significantly correlate negatively with the peak-systolic velocity of the hepatic artery in the acute phase [r=-0.341, P < 0.05] and correlate highly significant with the end-diastolic velocity [r=- 0.837, P < 0. 01]. We conclude that Doppler sonography is useful for imaging hepatic hemodynamic changes in patients with acute viral hepatitis. We found that significant changes occur only in hepatic artery while no changes occurred in the portal vein. Also measurement of hepatic arterial flow during acute phase may be a convenental and reliable of determining the prognosis of patients with viral hepatitis where the increased hepatic arterial blood flow during the acute phase may provide a marker for earlier recovery from hepatitis-induced damage and may be considered as a good marker for the prognosis