Ultrasound of Hepatic Vessels in Fatty Liver Disease
Correspondence Address :
Dr. Priya R Bhole,
Postgraduate Resident, Department of Radiology,
Smt. Kashibai Navale Medical College and General
Hospital, S.No. 49/1, Narhe, Off Mumbai-Pune Bypass,
Pune-411041, Maharashtra, India.
Introduction:Fatty liver is characterised by triglyceride accumulation within the cytoplasm of hepatocytes and is graded based on degree of increased liver echotexture on ultrasonography. Various disease processes affecting liver including fatty liver have characteristic effect on haemodynamics of the liver and affect the hepatic vessels waveforms.
Aim: The purpose of the study was to investigate the effect of the fatty liver disease on hepatic artery Resistive Index (RI) and hepatic vein waveform.
Materials and Methods: Total 119 patients were examined using B-mode and Doppler sonography. Patients were divided into Grade 0 (control group) with normal liver and Grade 1, 2, 3 according to severity of fatty liver. According to the waveform patterns, the hepatic vein waveforms were classified into three groups: triphasic, biphasic and monophasic patterns. The hepatic artery was sampled at porta hepatis and RI was calculated. Statistical analysis was performed using SPSS software with application of ANOVA test and t-test.
Results:Thirty-nine patients with Grade 1, 29 patients with Grade 2, 11 patients with Grade 3 fatty liver and 40 subjects in control group were included in present study. Mean hepatic artery RI was 0.75±0.03 in control group and 0.62±0.07 in the Grade 1, 0.59±0.04 in the Grade 2 and 0.59±0.07 in the Grade 3 fatty liver groups. The difference in mean hepatic artery RI amongst the control and fatty liver groups was found to be statistically significant (p<0.001). Abnormal hepatic vein waveform (biphasic/ monophasic) was seen in 52 (65.8 %) out of 79 patients of fatty liver. The incidence of abnormal hepatic vein waveform increased as the ultrasound severity grade of fatty liver increased and difference between control and fatty liver groups was found to be statistically significant (p<0.001).
Conclusion: The hepatic artery RI decreases as the severity grades of fatty liver increases. The difference in the mean hepatic artery RI amongst various grades of fatty liver was statistically significant (p<0.001). The incidence of abnormal hepatic vein waveforms (biphasic/monophasic) increases as severity of fatty liver increases and the difference between control and fatty liver groups was statistically significant (p<0.001).
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