Doppler ultrasound evaluation of effect of spleen spontaneous shunt on portal vein hemodynamics in patients with liver cirrhosis / 中国医学影像技术

ABSTRACT

Objective To investigate the effect of spleen spontaneous shunt on portal vein hemodynamics in patients with liver cirrhosis with Doppler ultrasound. Methods Eighty-seven patients were divided into chronic hepatitis group, liver cirrhosis group and control group. Liver function of cirrhosis patients was classified into Child A and Child B/C according to Child-Pugh categorization criteria. Hemodynamic parameters of hepatic artery, portal vein, superior mesenteric artery/vein and spleen artery/vein were examined on resting condition. Then the blood shunt ratio of spleen vein and superior mesenteric vein with portal vein, as well as hepatic circulation index (HCI) were calculated. The relationship between spleen blood shunt and HCI was analyzed. Results Portal vein blood flow was not significantly different among groups. Spleen vein blood flow increased in cirrhosis group, which was significantly different to that of control group and chronic hepatitis group. The spleen shunt ratio of cirrhosis group was greater than that of control group and chronic hepatitis group, as well as the Child B/C and Child A in cirrhosis group;the ratio of spleen vein flow to portal vein flow and spleen vein flow to superior mesenteric vein flow increased, but the ratio of superior mesenteric vein flow to portal vein flow decreased with the liver function decreased in cirrhosis group. There was non-linear negative correlation between HCI and the spleen shunt ratio. Conclusion Spleen spontaneous shunt and splenic hyperdynamic circulation play an important role in liver perfusion. Detecting Vspv/Vpv ratio with Doppler ultrasound in patients with liver cirrhosis is helpful in assessing liver function reserve.