|Title:||The value of hepatic haemodynamic parameters measured by Doppler ultrasound in diagnosis of fatty liver disease|
Hong Kong Polytechnic University -- Dissertations
Department of Optometry and Radiography
|Pages:||vi, 108 leaves : ill. (some col.) ; 30 cm|
|Abstract:||The spectrum of fatty liver disease (FLD) ranges from pure fatty liver to fatty liver hepatitis. It acquires a slow, silent but progressing destructive nature. B-mode ultrasound is usually considered as the initial screening modality for the disease due to the high sensitivity and well-established sonographic features. However, those sonographic features used in grading and diagnosing fatty liver disease are subjective and observer dependent. Previous studies have confirmed the value of Doppler measurement of haemodynamic changes caused by various hepatic parenchymal diseases. However, most of them were focused on more severe clinical conditions such as chronic or acute hepatitis and cirrhosis. Haemodynamic changes caused by fatty infiltration of the liver were seldom investigated. Doppler measurement of those haemodynamic changes caused by fatty infiltration of the liver may provide quantitative assessment of the disease. Duplex Doppler flow measurements were performed on 38 patients with ultrasound proved fatty liver and 30 healthy subjects. Mean flow velocity (PVV) and flow volume of the portal vein was found to be higher in disease group. Mean cross-sectional area of portal trunk was not different significantly between two groups. Pulsatility index (HA-PI) and resistive index (HA-RI) of the right hepatic artery were elevated in patients with fatty liver. Whereas QXt ratio of the Doppler velocity waveform (VPI) of the hepatic vein was higher in patients with fatty liver. The VPI did not show significant different among two groups. When using 0.1 ms-1 and 60 ml min-1 as the cut-off value for PVV and flow volume, the sensitivity and specificity of these two indices in detecting fatty infiltration of the liver were 75% and 83% for PVV; 62.5% and 67.5% for flow volume respectively. When using 1.0 and 0.71 as the cut-off value of HA-PI and HA-RI, the sensitivity and specificity of these two indices were 75% and 87.5% for HA-PI; 80% and 77.5% for HA-RI respectively. When using 0.85 at the cut-off value, the sensitivity and specificity of QXt ratio was 87.5% and 65% respectively. However, changes in these haemodynamic parameters do not readily predict the severity of the disease.|
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