Noninvasive evaluation on portal pressure change in patients with portal hypertension by ultrasound

Objective To study the relationship between portal hemodynamic parameters obtained by Doppler ultrasonography and portal pressure measured directly during surgery in patients with portal hypertension(PHT). Methods Fifty-seven patients with a clinical diagnosis of PHT who received surgery in Tangdu Hospital from 2008 to 2016 were investigated.Of the 57 cases,there were42 males and 15 females with mean age of 47 years.The portal pressure was measured directly intraoperatively.Relevant parameters,including congestion index(CI)of the portal vein,hepatic buffer index(HBI),liver vascular index(LVI),and PHT index(PHI),were collected by color Doppler ultrasonography,and their relationships with portal pressure were analyzed.Another 25 healthy adults with gender and age matched were included as control subjects. Results The CI and PHI of PHT patients were significantly higher than those of the healthy control groupCI,(0.127±0.067)cm/s v.s(0.045±0.035)cm/s; HBI,(2.093±0.506)s/m vs(1.393 ±0.520)s/m;P<0.01,respectively.While HBI and LVI were significantly lower than those of control group(1.389±0.813)min/L v.s(3.728±0.541)min/L;(10.308±3.260)cm/s v.s(16.257±5.760)cm/s;P<0.05,respectively.Portal pressure and LVI was significantly negatively correlated(r=-0.501,P=0.003),while HBI was significantly positively correlated with portal pressure(r=0.441,P=0.009).In addition,portal pressure and Child-Pugh score of liver function(r=0.589,P=0.044)was significantly positively correlated. Conclusion Color Doppler ultrasonography can noninvasively evaluate the progress of PHT.With the increase of portal venous pressure,hepatic vascular resistance increases.At the same time,hepatic buffer capacity of hepatic artery is started to compensate for the increase of vascular resistance.