Diagnostic value of Doppler assessment of the hepatic and portal vessels and ultrasound of the spleen in liver disease
OBJECTIVESTo investigate the clinical utility and the intra-observer and inter-observer variability of Doppler ultrasound assessment of the hepatic and portal vessels along with measurement of spleen size in the diagnosis of chronic liver disease and cirrhosis. METHODS AND MATERIALSUltrasound measur...
Gespeichert in:
| Veröffentlicht in: | European journal of gastroenterology & hepatology 2004-02, Vol.16 (2), p.147-155 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 155 |
|---|---|
| container_issue | 2 |
| container_start_page | 147 |
| container_title | European journal of gastroenterology & hepatology |
| container_volume | 16 |
| creator | O'Donohue, John Ng, Chaan Catnach, Susan Farrant, Patricia Williams, Roger |
| description | OBJECTIVESTo investigate the clinical utility and the intra-observer and inter-observer variability of Doppler ultrasound assessment of the hepatic and portal vessels along with measurement of spleen size in the diagnosis of chronic liver disease and cirrhosis.
METHODS AND MATERIALSUltrasound measurements of portal vein diameter (PVD), portal vein velocity (PVV), hepatic arterial resistance index (HARI), hepatic vein profile (HVP), and spleen size were obtained in 49 controls and 45 patients with liver disease (23 with primary biliary cirrhosis, 22 with hepatitis C) by two experienced observers, who each performed three blinded measurements of each variable. Control values were derived from normal hospital workers. Percutaneous liver biopsies in 41 of the patients showed cirrhosis (14 patients), moderate/severe fibrosis (13 patients), and early disease (14 patients).
RESULTSSeventy-one percent of cirrhotic patients had splenomegaly (> 13.6 cm). The spleen size was significantly larger in cirrhotics (16.0 cm) than in non-cirrhotics (13.0 cm, P < 0.009) and healthy controls (10.7 cm, P < 0.00005), and was the only independent predictor of cirrhosis, with a threshold of 15 cm predicting cirrhosis with a specificity of 98%, positive predictive value of 93%, sensitivity of 57% and negative predictive value of 80%. HVP was abnormal in 76.9% of cirrhotics, 57.7% of non-cirrhotics and 2.1% of controls (P < 0.04). However, the mean PVV, PVD and HARI were no different between controls and patients or between cirrhotic and non-cirrhotic liver disease. There was significant inter-observer variability for PVV, but intra-observer and inter-observer variability was acceptable for the other measurements.
CONCLUSIONSSplenomegaly size and abnormal HVP are useful predictors of chronic liver disease and cirrhosis, and both can be measured reliably and reproducibly. However, Doppler measurements of PVV, PVD and HARI are not useful in distinguishing patients with chronic liver disease from normal controls. |
| doi_str_mv | 10.1097/00042737-200402000-00005 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71819961</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>71819961</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4525-b8739c63d594edb5ea9f305e9e0cc88516ddd96dea6b2e1b4901860d7644a86a3</originalsourceid><addsrcrecordid>eNp1kU1v1DAQhi1ERZfCX0C-wC1gb_wRH1FbPqRKXFqpN2sST9iANw6eZCv-Pd5u-Lhw8Hg0et53pHcY41K8lcLZd0IItbW1rbalEaWIqjyhn7CNVLautGnsU7YRTqvKOHl_zp4TfRNC2lraZ-xcamG1a-yGHa4G-DommoeOHyAuyFPPr9I0RcwciJBoj-N8nM475Duc4IjCGPiU8gyRHwqCkR5HS5wzUFpKuwqoGOHIh5HH4VAsw0AIhC_YWQ-R8OX6X7C7D9e3l5-qmy8fP1--v6k6pbe6ahtbu87UQTuFodUIrq-FRoei65pGSxNCcCYgmHaLslVOyMaIYI1S0BioL9ibk--U048Fafb7gTqMEUZMC3krG-mckQVsTmCXE1HG3k952EP-6aXwx8z978z9n8z9Y-ZF-mrdsbR7DH-Fa8gFeL0CQB3EPsPYDfQPp6Sx0hVOnbiHFGfM9D0uD5j9DiHOO_-_m9e_AL9-mow</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71819961</pqid></control><display><type>article</type><title>Diagnostic value of Doppler assessment of the hepatic and portal vessels and ultrasound of the spleen in liver disease</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>O'Donohue, John ; Ng, Chaan ; Catnach, Susan ; Farrant, Patricia ; Williams, Roger</creator><creatorcontrib>O'Donohue, John ; Ng, Chaan ; Catnach, Susan ; Farrant, Patricia ; Williams, Roger</creatorcontrib><description>OBJECTIVESTo investigate the clinical utility and the intra-observer and inter-observer variability of Doppler ultrasound assessment of the hepatic and portal vessels along with measurement of spleen size in the diagnosis of chronic liver disease and cirrhosis.
METHODS AND MATERIALSUltrasound measurements of portal vein diameter (PVD), portal vein velocity (PVV), hepatic arterial resistance index (HARI), hepatic vein profile (HVP), and spleen size were obtained in 49 controls and 45 patients with liver disease (23 with primary biliary cirrhosis, 22 with hepatitis C) by two experienced observers, who each performed three blinded measurements of each variable. Control values were derived from normal hospital workers. Percutaneous liver biopsies in 41 of the patients showed cirrhosis (14 patients), moderate/severe fibrosis (13 patients), and early disease (14 patients).
RESULTSSeventy-one percent of cirrhotic patients had splenomegaly (> 13.6 cm). The spleen size was significantly larger in cirrhotics (16.0 cm) than in non-cirrhotics (13.0 cm, P < 0.009) and healthy controls (10.7 cm, P < 0.00005), and was the only independent predictor of cirrhosis, with a threshold of 15 cm predicting cirrhosis with a specificity of 98%, positive predictive value of 93%, sensitivity of 57% and negative predictive value of 80%. HVP was abnormal in 76.9% of cirrhotics, 57.7% of non-cirrhotics and 2.1% of controls (P < 0.04). However, the mean PVV, PVD and HARI were no different between controls and patients or between cirrhotic and non-cirrhotic liver disease. There was significant inter-observer variability for PVV, but intra-observer and inter-observer variability was acceptable for the other measurements.
CONCLUSIONSSplenomegaly size and abnormal HVP are useful predictors of chronic liver disease and cirrhosis, and both can be measured reliably and reproducibly. However, Doppler measurements of PVV, PVD and HARI are not useful in distinguishing patients with chronic liver disease from normal controls.</description><identifier>ISSN: 0954-691X</identifier><identifier>EISSN: 1473-5687</identifier><identifier>DOI: 10.1097/00042737-200402000-00005</identifier><identifier>PMID: 15075987</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Blood Flow Velocity - physiology ; Chronic Disease ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatic Artery - diagnostic imaging ; Hepatic Veins - diagnostic imaging ; Hepatitis C, Chronic - diagnostic imaging ; Hepatitis C, Chronic - physiopathology ; Humans ; Liver Cirrhosis, Biliary - diagnostic imaging ; Liver Cirrhosis, Biliary - physiopathology ; Liver Diseases - diagnostic imaging ; Liver Diseases - physiopathology ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Portal Vein - diagnostic imaging ; Predictive Value of Tests ; Reproducibility of Results ; Spleen - diagnostic imaging ; Ultrasonography ; Vascular Resistance - physiology</subject><ispartof>European journal of gastroenterology & hepatology, 2004-02, Vol.16 (2), p.147-155</ispartof><rights>2004 Lippincott Williams & Wilkins, Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4525-b8739c63d594edb5ea9f305e9e0cc88516ddd96dea6b2e1b4901860d7644a86a3</citedby><cites>FETCH-LOGICAL-c4525-b8739c63d594edb5ea9f305e9e0cc88516ddd96dea6b2e1b4901860d7644a86a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15416719$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15075987$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Donohue, John</creatorcontrib><creatorcontrib>Ng, Chaan</creatorcontrib><creatorcontrib>Catnach, Susan</creatorcontrib><creatorcontrib>Farrant, Patricia</creatorcontrib><creatorcontrib>Williams, Roger</creatorcontrib><title>Diagnostic value of Doppler assessment of the hepatic and portal vessels and ultrasound of the spleen in liver disease</title><title>European journal of gastroenterology & hepatology</title><addtitle>Eur J Gastroenterol Hepatol</addtitle><description>OBJECTIVESTo investigate the clinical utility and the intra-observer and inter-observer variability of Doppler ultrasound assessment of the hepatic and portal vessels along with measurement of spleen size in the diagnosis of chronic liver disease and cirrhosis.
METHODS AND MATERIALSUltrasound measurements of portal vein diameter (PVD), portal vein velocity (PVV), hepatic arterial resistance index (HARI), hepatic vein profile (HVP), and spleen size were obtained in 49 controls and 45 patients with liver disease (23 with primary biliary cirrhosis, 22 with hepatitis C) by two experienced observers, who each performed three blinded measurements of each variable. Control values were derived from normal hospital workers. Percutaneous liver biopsies in 41 of the patients showed cirrhosis (14 patients), moderate/severe fibrosis (13 patients), and early disease (14 patients).
RESULTSSeventy-one percent of cirrhotic patients had splenomegaly (> 13.6 cm). The spleen size was significantly larger in cirrhotics (16.0 cm) than in non-cirrhotics (13.0 cm, P < 0.009) and healthy controls (10.7 cm, P < 0.00005), and was the only independent predictor of cirrhosis, with a threshold of 15 cm predicting cirrhosis with a specificity of 98%, positive predictive value of 93%, sensitivity of 57% and negative predictive value of 80%. HVP was abnormal in 76.9% of cirrhotics, 57.7% of non-cirrhotics and 2.1% of controls (P < 0.04). However, the mean PVV, PVD and HARI were no different between controls and patients or between cirrhotic and non-cirrhotic liver disease. There was significant inter-observer variability for PVV, but intra-observer and inter-observer variability was acceptable for the other measurements.
CONCLUSIONSSplenomegaly size and abnormal HVP are useful predictors of chronic liver disease and cirrhosis, and both can be measured reliably and reproducibly. However, Doppler measurements of PVV, PVD and HARI are not useful in distinguishing patients with chronic liver disease from normal controls.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity - physiology</subject><subject>Chronic Disease</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hepatic Artery - diagnostic imaging</subject><subject>Hepatic Veins - diagnostic imaging</subject><subject>Hepatitis C, Chronic - diagnostic imaging</subject><subject>Hepatitis C, Chronic - physiopathology</subject><subject>Humans</subject><subject>Liver Cirrhosis, Biliary - diagnostic imaging</subject><subject>Liver Cirrhosis, Biliary - physiopathology</subject><subject>Liver Diseases - diagnostic imaging</subject><subject>Liver Diseases - physiopathology</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Portal Vein - diagnostic imaging</subject><subject>Predictive Value of Tests</subject><subject>Reproducibility of Results</subject><subject>Spleen - diagnostic imaging</subject><subject>Ultrasonography</subject><subject>Vascular Resistance - physiology</subject><issn>0954-691X</issn><issn>1473-5687</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1v1DAQhi1ERZfCX0C-wC1gb_wRH1FbPqRKXFqpN2sST9iANw6eZCv-Pd5u-Lhw8Hg0et53pHcY41K8lcLZd0IItbW1rbalEaWIqjyhn7CNVLautGnsU7YRTqvKOHl_zp4TfRNC2lraZ-xcamG1a-yGHa4G-DommoeOHyAuyFPPr9I0RcwciJBoj-N8nM475Duc4IjCGPiU8gyRHwqCkR5HS5wzUFpKuwqoGOHIh5HH4VAsw0AIhC_YWQ-R8OX6X7C7D9e3l5-qmy8fP1--v6k6pbe6ahtbu87UQTuFodUIrq-FRoei65pGSxNCcCYgmHaLslVOyMaIYI1S0BioL9ibk--U048Fafb7gTqMEUZMC3krG-mckQVsTmCXE1HG3k952EP-6aXwx8z978z9n8z9Y-ZF-mrdsbR7DH-Fa8gFeL0CQB3EPsPYDfQPp6Sx0hVOnbiHFGfM9D0uD5j9DiHOO_-_m9e_AL9-mow</recordid><startdate>200402</startdate><enddate>200402</enddate><creator>O'Donohue, John</creator><creator>Ng, Chaan</creator><creator>Catnach, Susan</creator><creator>Farrant, Patricia</creator><creator>Williams, Roger</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><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>200402</creationdate><title>Diagnostic value of Doppler assessment of the hepatic and portal vessels and ultrasound of the spleen in liver disease</title><author>O'Donohue, John ; Ng, Chaan ; Catnach, Susan ; Farrant, Patricia ; Williams, Roger</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4525-b8739c63d594edb5ea9f305e9e0cc88516ddd96dea6b2e1b4901860d7644a86a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity - physiology</topic><topic>Chronic Disease</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hepatic Artery - diagnostic imaging</topic><topic>Hepatic Veins - diagnostic imaging</topic><topic>Hepatitis C, Chronic - diagnostic imaging</topic><topic>Hepatitis C, Chronic - physiopathology</topic><topic>Humans</topic><topic>Liver Cirrhosis, Biliary - diagnostic imaging</topic><topic>Liver Cirrhosis, Biliary - physiopathology</topic><topic>Liver Diseases - diagnostic imaging</topic><topic>Liver Diseases - physiopathology</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Portal Vein - diagnostic imaging</topic><topic>Predictive Value of Tests</topic><topic>Reproducibility of Results</topic><topic>Spleen - diagnostic imaging</topic><topic>Ultrasonography</topic><topic>Vascular Resistance - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Donohue, John</creatorcontrib><creatorcontrib>Ng, Chaan</creatorcontrib><creatorcontrib>Catnach, Susan</creatorcontrib><creatorcontrib>Farrant, Patricia</creatorcontrib><creatorcontrib>Williams, Roger</creatorcontrib><collection>Pascal-Francis</collection><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>European journal of gastroenterology & hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Donohue, John</au><au>Ng, Chaan</au><au>Catnach, Susan</au><au>Farrant, Patricia</au><au>Williams, Roger</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic value of Doppler assessment of the hepatic and portal vessels and ultrasound of the spleen in liver disease</atitle><jtitle>European journal of gastroenterology & hepatology</jtitle><addtitle>Eur J Gastroenterol Hepatol</addtitle><date>2004-02</date><risdate>2004</risdate><volume>16</volume><issue>2</issue><spage>147</spage><epage>155</epage><pages>147-155</pages><issn>0954-691X</issn><eissn>1473-5687</eissn><abstract>OBJECTIVESTo investigate the clinical utility and the intra-observer and inter-observer variability of Doppler ultrasound assessment of the hepatic and portal vessels along with measurement of spleen size in the diagnosis of chronic liver disease and cirrhosis.
METHODS AND MATERIALSUltrasound measurements of portal vein diameter (PVD), portal vein velocity (PVV), hepatic arterial resistance index (HARI), hepatic vein profile (HVP), and spleen size were obtained in 49 controls and 45 patients with liver disease (23 with primary biliary cirrhosis, 22 with hepatitis C) by two experienced observers, who each performed three blinded measurements of each variable. Control values were derived from normal hospital workers. Percutaneous liver biopsies in 41 of the patients showed cirrhosis (14 patients), moderate/severe fibrosis (13 patients), and early disease (14 patients).
RESULTSSeventy-one percent of cirrhotic patients had splenomegaly (> 13.6 cm). The spleen size was significantly larger in cirrhotics (16.0 cm) than in non-cirrhotics (13.0 cm, P < 0.009) and healthy controls (10.7 cm, P < 0.00005), and was the only independent predictor of cirrhosis, with a threshold of 15 cm predicting cirrhosis with a specificity of 98%, positive predictive value of 93%, sensitivity of 57% and negative predictive value of 80%. HVP was abnormal in 76.9% of cirrhotics, 57.7% of non-cirrhotics and 2.1% of controls (P < 0.04). However, the mean PVV, PVD and HARI were no different between controls and patients or between cirrhotic and non-cirrhotic liver disease. There was significant inter-observer variability for PVV, but intra-observer and inter-observer variability was acceptable for the other measurements.
CONCLUSIONSSplenomegaly size and abnormal HVP are useful predictors of chronic liver disease and cirrhosis, and both can be measured reliably and reproducibly. However, Doppler measurements of PVV, PVD and HARI are not useful in distinguishing patients with chronic liver disease from normal controls.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>15075987</pmid><doi>10.1097/00042737-200402000-00005</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0954-691X |
| ispartof | European journal of gastroenterology & hepatology, 2004-02, Vol.16 (2), p.147-155 |
| issn | 0954-691X 1473-5687 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_71819961 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Biological and medical sciences Blood Flow Velocity - physiology Chronic Disease Female Gastroenterology. Liver. Pancreas. Abdomen Hepatic Artery - diagnostic imaging Hepatic Veins - diagnostic imaging Hepatitis C, Chronic - diagnostic imaging Hepatitis C, Chronic - physiopathology Humans Liver Cirrhosis, Biliary - diagnostic imaging Liver Cirrhosis, Biliary - physiopathology Liver Diseases - diagnostic imaging Liver Diseases - physiopathology Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Other diseases. Semiology Portal Vein - diagnostic imaging Predictive Value of Tests Reproducibility of Results Spleen - diagnostic imaging Ultrasonography Vascular Resistance - physiology |
| title | Diagnostic value of Doppler assessment of the hepatic and portal vessels and ultrasound of the spleen in liver disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T11%3A35%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diagnostic%20value%20of%20Doppler%20assessment%20of%20the%20hepatic%20and%20portal%20vessels%20and%20ultrasound%20of%20the%20spleen%20in%20liver%20disease&rft.jtitle=European%20journal%20of%20gastroenterology%20&%20hepatology&rft.au=O'Donohue,%20John&rft.date=2004-02&rft.volume=16&rft.issue=2&rft.spage=147&rft.epage=155&rft.pages=147-155&rft.issn=0954-691X&rft.eissn=1473-5687&rft_id=info:doi/10.1097/00042737-200402000-00005&rft_dat=%3Cproquest_cross%3E71819961%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=71819961&rft_id=info:pmid/15075987&rfr_iscdi=true |