Title: Doppler Sonography for Surrogate Markers of Gastro-Oesophageal Varices in Chronic Liver Disease

Authors: V.S. Sudhakaran, N.J. John

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.83

Abstract

 

Introduction: Gastro-oesophageal varices lead to a major cause of morbidity and mortality in CLD with Portal Hypertension requiring repeated endoscopies for diagnosis and follow up. Sonographic surrogate markers for varices are being searched for and evaluated to aid in diagnosis and follow up.

Aim of the work: To determine the accuracy of primary Doppler indices of hepatic artery, splenic artery, middle hepatic vein, superior mesenteric artery and calculated complex Doppler parameters in diagnosis of oesophageal varices.

Patients and Methods: 96 cases of CLD underwent Doppler sonography of portal venous system, hepatic arteries and hepatic veins. Conventional Doppler parameters, liver congestion index, liver vascular index and portal hypertension index were noted. Patients underwent endoscopy for detecting and grading varices. The Doppler findings were correlated with endoscopy findings.

Results: PSV, RI and PI values alone of splenic artery, hepatic artery and SMA do not correspond to presence or absence of varices. Liver congestive index, liver vascular index and portal hypertension index and wave forms in middle hepatic vein show correlation with presence or absence of varices.

Conclusions: Liver congestion index >0.145 cm x s, liver vascular index < 12 cm/s, portal hypertension index >0.021s/cm and monophasic/biphasic wave form in middle hepatic vein can be used as sonographic surrogate markers for presence of gastro-oesophageal varices in portal hypertension.

Keywords: Chronic Liver Disease, gastro-oesophageal varices, Doppler Sonography, Liver congestion index, liver vascular index and portal hypertension index, Middle hepatic vein wave form.

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Corresponding Author

N.J. John

Associate Professor, Dept. of Radiodiagnosis, Govt. Medical College Hospital, Medical College PO, Trivandrum, Kerala, Pin 695011, India

Ph: 9447553678, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.