Evaluation of portal hypertension esophageal varices (moderate to severe) via liver ultrasound hemodynamic parameters / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the application of liver ultrasound hemodynamic parameters in diagnosing moderate to severe esophageal varices(EV) among patients suffering from portal hypertension.Methods The control group consisted of twenty nine patients without EV.Sixty patients with EV diagnosed by endoscopy were divided into two groups equal in number according to grade of EV.One being mild,the other was moderate to severe.All patients underwent color Doppler flow imaging and contrastenhanced ultrasound,and the dynamic angiography data were collected.Time intensity curves were drawn by software to acquire the arrive time of hepatic artery (HAAT),hepatic vein (HVAT) and portal vein (PVAT).Then HV-HA interval time,PV HA interval time and PV-HV interval time were calculated.The quantitative parameters including HV-HA,PV-HA,PV-HV,damping index (DI) of hepatic vein and portal vein velocity(PVV) were compared.ROC curve was used to assess the value of the parameters above in predicting moderate to severe esophageal varices.Results The difference of PV-HV,PV HA,HV-HA,PVV,DI between the control and the moderate to severe group were statistically significant (P =0.000).PV-HV,PV-HA,HV-HA,DI in moderate to severe group showed statistically significant compared with mild group (P =0.000,P =0.002,P =0.000,P =0.002),however,PVV had no significant (P ＞0.05) difference between the two groups.Mild group contrasted to the control group,the differences of PV-HA and HV-HA were statistically significant (P =0.000),whereas PV-HV,DI,PVV displayed no significant (P ＞0.05) difference.The areas under ROC curve of PV-HV,PV-HA,HV-HA,PVV,DI were 0.952,0.775,0.847,0.699,0.808 respectively.The best cutoff value of PV-HV for diagnosing moderate to severe EV was 0.5 second,with sensitivity and specificity of 86.2％ and 94.8％ respectively.Conclusions The liver ultrasound hemodynamic parameters is helpful in the diagnosis and evaluation of moderate to severe esophageal varices,which is expected to become a new noninvasive method.