الفهرس | Only 14 pages are availabe for public view |
Abstract Liver cirrhosis is one of the major health problems in Egypt. Liver biopsy & histopathological study is still the most accurate method for diagnosis of liver cirrhosis. However, this invasive procedure is hazardous, especially considering the bleeding tendency of these patients. Doppler ultrasound has been widely used in recent years and it can be of great help as a non-invasive technique for diagnosis of liver disease.The aim of this work is to assess the changes of the Doppler waveform of the hepatic veins in cirrhotic patients.We studied 50 patients with histopathologically proved liver cirrhosis of variable stages according to child-Pugh classification. Another group of 20 normal volunteers were examined in the same way.The waveform of the hepatic veins was classified into three patterns: HV0, a normal triphasic waveform; HV1 lower oscillations without the reversed phase; and HV2, completely flat waveform.The waveform of hepatic veins in all healthy subjects corresponded to the HU0 pattern.The severity of functional impairment of the liver was greatest in the HV2 group and least in the HVO group.The pathophysiology of these changes in hepatic vein blood flow is still unclear.The most accepted explanation for these changes is the stiffness or decreased compliance of the diseased liver.Changes in the normal hepatic veins waveform could be considered an adjunctive sign of liver disease and are somewhat related to the severity of functional impairment.Its exact role in patient management remains to be determined, and we need a mathematical formula which we can apply to these new waves to grade the severity of the changes.We hope the near future studies will deliver the answer of this question. |