J Korean Soc Med Ultrasound.  1999 Dec;18(4):275-281.

Doppler Wave form of Hepatic Vein in Patients with Chronic Hepatitis B: Correlation with Histologic Grade and Stage

• Eom KT
• Namkung S
• Bae SH
• Choi YH

Abstract

PURPOSE: To evaluate the relationship between the waveform of the right hepatic vein and the histological gradeand stage in patients with chronic hepatitis B.
MATERIALS and METHODS
Eighty-seven patients with chronic hepatitis B were examined prospectively by one sonographer. In each patient, Doppler waveform of the right hepatic vein was obtained. Doppler waveform was classified into 3 types, type 0: normal triphasic pattern, type 1: reduced amplitude of phasic oscillation and no reverse flow phase, and type2: completely flat flow pattern. In the same session, an ultrasound guided liver biopsy was performed and submitted to one pathologist for grading and staging. Duplex doppler ultrasonography of the right hepatic vein was also performed in 12 control subjects with no evidence of liver or heart disease. The doppler waveform was compared with the histologic severity and a statistical analysis was performed.
RESULTS
In the control group, all cases had type 0 waveform. In the hepatitis group, there were type 0 waveform in 61 cases (70.1%), type 1 waveform in 22 cases (25.3%) and type 2 waveform in 4 cases (4.6%). The frequency of abnormal waveforms is significantly higher in patients with grade 3-4 and stage 3-4 than grade and stage 1-2 (p<0.005). In the hepatitis group, the venous pulsatility index (VPI) was 0.17-0.69 (mean 0.41), and decreased in the highest and mean values when increasing the histologic scores. However, it was not significant statistically ( p > 0 . 0 5 ) .
CONCLUSION
The frequency of abnormal waveform was correlated with the histologic severity in patients with chronic hepatitis B. The highest and mean values of the VPI were also correlated. However 70.1% of the patients with chronic hepatitis B showed normal waveform. So doppler ultrasonogram of the hepatic vein may be useful for the diagnosis and the differential diagnosis from cirrhosis in patients with chronic hepatitis B by combination of doppler waveform and venous pulsatility index.

MeSH Terms

Biopsy
Diagnosis
Diagnosis, Differential
Fibrosis
Heart Diseases
Hepatic Veins*
Hepatitis
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Liver
Prospective Studies
Ultrasonography
Ultrasonography, Doppler, Duplex