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Abstract
The accuracy of various Doppler parameters of portal circulation in the diagnosis of relevant portal hypertension was prospectively validated.Duplex ultrasound allows direct access to portal venous and hepatic vein haemodynamics. This method has been accepted as a reliable procedure to detect portal and splenic venous thrombosis, Budd Chiari’s syndrome, portosystemic collateralization and changes in the portal venous blood direction with a high rate of sensitivity. Recently, it was found that Doppler is a valuable tool for follow up in medical and surgical treatment of portal hypertension.
Also, some patients look too good to have varices, as they have no other stigmata of cirrhosis after their initial variceal bleeding, and have no definable risk factors for liver disease. Doppler ultrasound after portal vein may strongly suggest the diagnosis.
The aim of this work was to assess he clinical role of duplex Doppler techniques in evaluation of the portal venous system in different pathological conditions.
The study included 50 patients. Control group of 15 volunteers, with non of them had history or clinical findings of liver diseases, and normal function tests, was used to assess the normal sonographic appearance and normal blood flow in the portal venous system.
The patients were divided according to Child-Pough classification into three groups:
Grade A group: score between 5 – 6 points (28 patients)
Grade B group: score between 7 – 9 points (14 patients)
Grade C group: score more than 9 points (8 patients)
All patients were subjected to the following:
1- Full clinical history and examination.
2- Laboratory investigation
3- Ultrasonography in the form of :
a. B-mode ultrasound examination
b. Doppler US examination
4- Biopsy: were available for only 11 patients, So, we excluded it from the study. All obtained data for the patients were tabulated and compared with each other and with control group, So as to assess the role of duplex Doppler in evaluation of portal venous system.