Doppler assessment of splanchnic arterial flow in patients with liver cirrhosis: Correlation with ammonia plasma levels and MELD score

• Published in: Journal of clinical ultrasound Vol. 42; no. 5; pp. 264 - 269
• Main Authors: Glišić, Tijana M., Perišić, Mirjana D., Dimitrijevic, Sladjana, Jurišić, Vladimir
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.06.2014; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Ammonia - metabolism; ammonia level; Blood Flow Velocity - physiology; duplex Doppler ultrasonography; End Stage Liver Disease - blood; End Stage Liver Disease - diagnostic imaging; End Stage Liver Disease - physiopathology; Female; Flow velocity; Hepatic Artery - diagnostic imaging; Hepatic Artery - physiopathology; Humans; Hyperglycemia; Liver - blood supply; Liver - diagnostic imaging; Liver - physiopathology; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - diagnostic imaging; Liver Function Tests - methods; Liver Function Tests - statistics & numerical data; Male; MELD score; Middle Aged; Prospective Studies; Renal Artery - diagnostic imaging; Renal Artery - physiopathology; Severity of Illness Index; Splanchnic Circulation - physiology; Splenic Artery - diagnostic imaging; Splenic Artery - physiopathology; Ultrasonic imaging; Ultrasonography, Doppler, Duplex - methods; Vascular Resistance - physiology; Veins & arteries; ammonia level; duplex Doppler ultrasonography; MELD score; liver cirrhosis
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.22135

ABSTRACT Purpose To assess the clinical significance of blood flow velocity and resistance index (RI) in the visceral arteries of patients with liver cirrhosis with respect to plasma ammonia (NH3) level and liver function. Methods We included 80 patients with liver cirrhosis (58 men) and 20 healthy controls (11 men). Duplex Doppler ultrasonography was used to assess flow velocity and RI in the hepatic (HA), right (RRA), and left renal (LRA), and splenic (SA) (LA) artery. Plasma NH3 was measured by biochemistry. Liver function was assessed by MELD score (model of end‐stage liver disease). Results HA, LRA, and SA systolic flow velocities were greater, whereas RRA diastolic velocity was lower in patients with liver cirrhosis than in controls RI was higher in LRA, RRA, SA, and HA in patients with liver cirrhosis than in controls. NH3 levels were significantly elevated in all patients with liver cirrhosis (p < 0.05) and significantly correlated with RI of RRA, LRA, and SA. Conclusion We found greater renal, hepatic, and LA RI in patients with liver cirrhosis than in healthy controls. The correlation we found between elevated renal artery RI (≥0.70) and MELD score emphasizes the risk of renal dysfunction during progression of liver cirrhosis. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 42:264–269, 2014