Doppler Analysis of Hepatic Venous Waveforms: A Reliable Way to Diagnose and Guess the Size of Esophageal Varices in People with Cirrhosis of the Liver

ABSTRACT Objective: To determine the diagnostic accuracy of Doppler assessment of hepatic venous waveforms for predicting large esophageal varices in patients with cirrhosis, keeping esophagogastroduodenoscopy as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi Pakistan, from Jan 2021 to Jan 2022. Methodology: According to the Child-Pugh classification, 157 cases of liver cirrhosis were included in this study. With a convex probe operating at 3.5 to 5 MHz, a Doppler ultrasound was executed. If quiet breathing wasn't an option, the spectral waveform was captured at the end of the inhalation phase while holding your breath. This was roughly 3-6 cm from where it connects to the inferior vena cava. All patients underwent an esophagogastroduodenoscopy. Results: In Doppler USG-positive patients, 84 (true positive) developed significant esophageal varices on endoscopy, while 4 (false positive) did not. Among 69 individuals with negative Doppler USG results, six (false negative) had significant esophageal varices on endoscopy, whereas 63 (true negative) did not (p=0.0001). We found that the overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of Doppler evaluation of hepatic venous waveforms were 93.33%, 94.0%, 95.45%, 91.30%, and 93.6% for finding large esophageal varices in cirrhotic patients using esophagogastroduodenoscopy as the gold standard. Conclusion: This study proved that using Doppler to look at hepatic vein waveforms is a very sensitive and accurate noninvasive way to tell if someone with cirrhosis will get big esophageal varices.