The value of serial Doppler ultrasound as a predictor of clinical outcome and the need for transplantation in fulminant and severe acute liver failure
The aim of this study was to document the changes in Doppler ultrasound variables of the hepatic artery and portal vein in fulminant and severe acute liver failure, and to assess their prognostic significance. 18 adult patients with fulminant and severe acute liver failure underwent serial Doppler s...
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| Veröffentlicht in: | British journal of radiology 1999-02, Vol.72 (854), p.134-143 |
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| creator | Deasy, N P Wendon, J Meire, H B Sidhu, P S |
| description | The aim of this study was to document the changes in Doppler ultrasound variables of the hepatic artery and portal vein in fulminant and severe acute liver failure, and to assess their prognostic significance. 18 adult patients with fulminant and severe acute liver failure underwent serial Doppler sonography, in the early stages after presentation. 12 hourly measurements of hepatic artery resistance index (HARI), spleen length, portal vein cross-sectional area, time average velocity (TAV) and flow volume were performed. Mean HARI (p = 0.03) and mean maximum HARI (p = 0.03) were significantly higher in those who fulfilled criteria for liver transplantation. Increased portal vein flow was demonstrated, although the difference between the groups was not significant. A significant increase in portal vein cross-sectional area (p < 0.02) and spleen length (p < 0.02) was demonstrated. In summary, an increase in portal blood flow to the damaged liver has been demonstrated. The mean HARI is significantly higher in patients who fulfil transplant criteria and may possibly be used as an indicator of poorer prognosis and the need for liver transplantation in acute severe and fulminant liver failure. |
| doi_str_mv | 10.1259/bjr.72.854.10365062 |
| format | Article |
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Mean HARI (p = 0.03) and mean maximum HARI (p = 0.03) were significantly higher in those who fulfilled criteria for liver transplantation. Increased portal vein flow was demonstrated, although the difference between the groups was not significant. A significant increase in portal vein cross-sectional area (p < 0.02) and spleen length (p < 0.02) was demonstrated. In summary, an increase in portal blood flow to the damaged liver has been demonstrated. The mean HARI is significantly higher in patients who fulfil transplant criteria and may possibly be used as an indicator of poorer prognosis and the need for liver transplantation in acute severe and fulminant liver failure.</description><identifier>ISSN: 0007-1285</identifier><identifier>EISSN: 1748-880X</identifier><identifier>DOI: 10.1259/bjr.72.854.10365062</identifier><identifier>PMID: 10365062</identifier><language>eng</language><publisher>England</publisher><subject>Adolescent ; Adult ; Female ; Hepatic Artery - diagnostic imaging ; Hepatic Artery - physiopathology ; Hepatic Encephalopathy - diagnostic imaging ; Hepatic Encephalopathy - physiopathology ; Hepatic Encephalopathy - surgery ; Humans ; Liver Failure, Acute - diagnostic imaging ; Liver Failure, Acute - physiopathology ; Liver Failure, Acute - surgery ; Liver Transplantation ; Male ; Middle Aged ; Portal Vein - diagnostic imaging ; Prognosis ; Reproducibility of Results ; Ultrasonography, Doppler ; Vascular Resistance</subject><ispartof>British journal of radiology, 1999-02, Vol.72 (854), p.134-143</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c301t-ed8d02c1030743d4451d8634b5deb7af1b20b556ab46e061a46b570e07260f6b3</citedby><cites>FETCH-LOGICAL-c301t-ed8d02c1030743d4451d8634b5deb7af1b20b556ab46e061a46b570e07260f6b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10365062$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Deasy, N P</creatorcontrib><creatorcontrib>Wendon, J</creatorcontrib><creatorcontrib>Meire, H B</creatorcontrib><creatorcontrib>Sidhu, P S</creatorcontrib><title>The value of serial Doppler ultrasound as a predictor of clinical outcome and the need for transplantation in fulminant and severe acute liver failure</title><title>British journal of radiology</title><addtitle>Br J Radiol</addtitle><description>The aim of this study was to document the changes in Doppler ultrasound variables of the hepatic artery and portal vein in fulminant and severe acute liver failure, and to assess their prognostic significance. 18 adult patients with fulminant and severe acute liver failure underwent serial Doppler sonography, in the early stages after presentation. 12 hourly measurements of hepatic artery resistance index (HARI), spleen length, portal vein cross-sectional area, time average velocity (TAV) and flow volume were performed. Mean HARI (p = 0.03) and mean maximum HARI (p = 0.03) were significantly higher in those who fulfilled criteria for liver transplantation. Increased portal vein flow was demonstrated, although the difference between the groups was not significant. A significant increase in portal vein cross-sectional area (p < 0.02) and spleen length (p < 0.02) was demonstrated. In summary, an increase in portal blood flow to the damaged liver has been demonstrated. The mean HARI is significantly higher in patients who fulfil transplant criteria and may possibly be used as an indicator of poorer prognosis and the need for liver transplantation in acute severe and fulminant liver failure.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Female</subject><subject>Hepatic Artery - diagnostic imaging</subject><subject>Hepatic Artery - physiopathology</subject><subject>Hepatic Encephalopathy - diagnostic imaging</subject><subject>Hepatic Encephalopathy - physiopathology</subject><subject>Hepatic Encephalopathy - surgery</subject><subject>Humans</subject><subject>Liver Failure, Acute - diagnostic imaging</subject><subject>Liver Failure, Acute - physiopathology</subject><subject>Liver Failure, Acute - surgery</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Portal Vein - diagnostic imaging</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Ultrasonography, Doppler</subject><subject>Vascular Resistance</subject><issn>0007-1285</issn><issn>1748-880X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkV1LHTEQhkNR6lH7C4SSq97tabKbZHMuxbYqCL1R6F3IxyyNZDfbfAj-kf5ec_QIXg0zPO_LzLwIXVCypT3ffTePaTv2W8nZlpJBcCL6T2hDRyY7KcmfI7QhhIwd7SU_Qac5P-5bviOf0ck7v0H_7_8CftKhAo4TzpC8DvhHXNcACddQks6xLg7rjDVeEzhvS0x71ga_eNvoWIuNM2DdsNLcFgCHpwY18ZLXoJeii48L9gueapj90iavdIYnSE1oawEcfGvwpH2oCc7R8aRDhi-HeoYefv28v7rp7n5f315d3nV2ILR04KQjvW3nkJENjjFOnRQDM9yBGfVETU8M50IbJoAIqpkwfCRAxl6QSZjhDH17811T_FchFzX7bCG0pSHWrMROUskYbeDwBtoUc04wqTX5WadnRYnax6FaHGrsVYtDvb-3qb4e7KuZwX3QHIAX-dOJOw</recordid><startdate>19990201</startdate><enddate>19990201</enddate><creator>Deasy, N P</creator><creator>Wendon, J</creator><creator>Meire, H B</creator><creator>Sidhu, P S</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990201</creationdate><title>The value of serial Doppler ultrasound as a predictor of clinical outcome and the need for transplantation in fulminant and severe acute liver failure</title><author>Deasy, N P ; Wendon, J ; Meire, H B ; Sidhu, P S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c301t-ed8d02c1030743d4451d8634b5deb7af1b20b556ab46e061a46b570e07260f6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Female</topic><topic>Hepatic Artery - diagnostic imaging</topic><topic>Hepatic Artery - physiopathology</topic><topic>Hepatic Encephalopathy - diagnostic imaging</topic><topic>Hepatic Encephalopathy - physiopathology</topic><topic>Hepatic Encephalopathy - surgery</topic><topic>Humans</topic><topic>Liver Failure, Acute - diagnostic imaging</topic><topic>Liver Failure, Acute - physiopathology</topic><topic>Liver Failure, Acute - surgery</topic><topic>Liver Transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Portal Vein - diagnostic imaging</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Ultrasonography, Doppler</topic><topic>Vascular Resistance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Deasy, N P</creatorcontrib><creatorcontrib>Wendon, J</creatorcontrib><creatorcontrib>Meire, H B</creatorcontrib><creatorcontrib>Sidhu, P S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Deasy, N P</au><au>Wendon, J</au><au>Meire, H B</au><au>Sidhu, P S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The value of serial Doppler ultrasound as a predictor of clinical outcome and the need for transplantation in fulminant and severe acute liver failure</atitle><jtitle>British journal of radiology</jtitle><addtitle>Br J Radiol</addtitle><date>1999-02-01</date><risdate>1999</risdate><volume>72</volume><issue>854</issue><spage>134</spage><epage>143</epage><pages>134-143</pages><issn>0007-1285</issn><eissn>1748-880X</eissn><abstract>The aim of this study was to document the changes in Doppler ultrasound variables of the hepatic artery and portal vein in fulminant and severe acute liver failure, and to assess their prognostic significance. 18 adult patients with fulminant and severe acute liver failure underwent serial Doppler sonography, in the early stages after presentation. 12 hourly measurements of hepatic artery resistance index (HARI), spleen length, portal vein cross-sectional area, time average velocity (TAV) and flow volume were performed. Mean HARI (p = 0.03) and mean maximum HARI (p = 0.03) were significantly higher in those who fulfilled criteria for liver transplantation. Increased portal vein flow was demonstrated, although the difference between the groups was not significant. A significant increase in portal vein cross-sectional area (p < 0.02) and spleen length (p < 0.02) was demonstrated. In summary, an increase in portal blood flow to the damaged liver has been demonstrated. The mean HARI is significantly higher in patients who fulfil transplant criteria and may possibly be used as an indicator of poorer prognosis and the need for liver transplantation in acute severe and fulminant liver failure.</abstract><cop>England</cop><pmid>10365062</pmid><doi>10.1259/bjr.72.854.10365062</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-1285 |
| ispartof | British journal of radiology, 1999-02, Vol.72 (854), p.134-143 |
| issn | 0007-1285 1748-880X |
| language | eng |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adolescent Adult Female Hepatic Artery - diagnostic imaging Hepatic Artery - physiopathology Hepatic Encephalopathy - diagnostic imaging Hepatic Encephalopathy - physiopathology Hepatic Encephalopathy - surgery Humans Liver Failure, Acute - diagnostic imaging Liver Failure, Acute - physiopathology Liver Failure, Acute - surgery Liver Transplantation Male Middle Aged Portal Vein - diagnostic imaging Prognosis Reproducibility of Results Ultrasonography, Doppler Vascular Resistance |
| title | The value of serial Doppler ultrasound as a predictor of clinical outcome and the need for transplantation in fulminant and severe acute liver failure |
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