Hepatic arterial hemodynamics and model for end-stage liver disease (MELD) scores in chronic liver disease: insights from Doppler ultrasonography

IF 0.7 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Egyptian Journal of Radiology and Nuclear Medicine Pub Date : 2024-03-26 DOI:10.1186/s43055-024-01220-3
Sasmita Tuladhar, Shailendra Katwal, Ghanshyam Gurung, Umesh Khanal
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Abstract

Doppler ultrasonography is essential to provide insights into hemodynamic alterations and liver function changes in pre-cirrhotic and cirrhotic patients. Utilizing Doppler examinations, this study aims to explore the correlation between hepatic arterial hemodynamics and Model for end-stage liver disease (MELD) scores in chronic liver disease patients. A study of 50 chronic liver disease patients included sonographic assessments, measuring liver, portal vein size, and flow. Hepatic artery velocity, resistive index (RI), pulsatility index (PI), and acceleration time (AT) were evaluated. Biochemical parameters (serum bilirubin, creatinine, INR) were used to calculate MELD scores, compared with different Doppler sonographic parameters. The study found a mean peak systolic velocity (PSV) of 107.42 ± 48.10, with end-diastolic velocity (EDV) of 26.40 ± 14.68, RI of 0.74 ± 0.06, and PI of 1.47 ± 0.24. The mean MELD score was 19.28 ± 6.09. Correlations between MELD scores and PSV, EDV, RI, PI, and AT did not yield statistically significant correlations. 80% of subjects displayed high RI (> 0.7) values in the hepatic artery, and a significant correlation was found between portal vein thrombosis and hepatic artery PSV and RI (p < 0.05). Hepatic artery RI and PSV show a significant correlation with portal vein thrombosis. Doppler ultrasonography, while not directly tied to MELD scores, is valuable for non-invasive liver disease monitoring when invasive methods are impractical. Further research is needed to unravel the relationships between hemodynamic changes, MELD scores, and clinical outcomes in a broader patient population.
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慢性肝病的肝动脉血流动力学和终末期肝病模型(MELD)评分:多普勒超声波检查的启示
多普勒超声检查对于了解肝硬化前和肝硬化患者的血流动力学改变和肝功能变化至关重要。本研究利用多普勒检查,旨在探讨慢性肝病患者肝动脉血流动力学与终末期肝病模型(MELD)评分之间的相关性。对 50 名慢性肝病患者进行的研究包括声学评估,测量肝脏、门静脉大小和血流量。对肝动脉速度、阻力指数(RI)、脉动指数(PI)和加速时间(AT)进行了评估。生化参数(血清胆红素、肌酐、INR)用于计算 MELD 评分,并与不同的多普勒超声参数进行比较。研究发现,平均收缩峰值速度(PSV)为 107.42 ± 48.10,舒张末速度(EDV)为 26.40 ± 14.68,RI 为 0.74 ± 0.06,PI 为 1.47 ± 0.24。平均 MELD 评分为 19.28 ± 6.09。MELD 评分与 PSV、EDV、RI、PI 和 AT 之间的相关性没有统计学意义。80%的受试者肝动脉RI值较高(> 0.7),门静脉血栓与肝动脉PSV和RI之间存在显著相关性(P < 0.05)。肝动脉 RI 和 PSV 与门静脉血栓形成有显著相关性。多普勒超声虽然与 MELD 评分没有直接联系,但在有创方法不可行的情况下,对于无创肝病监测很有价值。要在更广泛的患者群体中揭示血液动力学变化、MELD 评分和临床结果之间的关系,还需要进一步的研究。
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来源期刊
Egyptian Journal of Radiology and Nuclear Medicine
Egyptian Journal of Radiology and Nuclear Medicine Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
1.70
自引率
10.00%
发文量
233
审稿时长
27 weeks
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