Correlation of MRI liver volume and Doppler sonographic portal hemodynamics with histologic findings in patients with chronic hepatitis C

Purpose The purpose of this study was to correlate portal hemodynamics on sonography and liver volume on MRI with histologic findings in asymptomatic patients with chronic hepatitis C. Methods Portal blood flow in the left and right portal branches in 20 healthy volunteers and in 26 patients was measured using Doppler sonography during both fasting and postprandial states. Total liver and right‐and left‐lobe volumes were determined using MRI. The ratio between portal blood flow and liver volume determined the “portal flow index” of the right and left lobes. Results We observed a statistically significant difference (p < 0.01) between the volunteers and patients in the mean left‐lobe volume (352 ± 81 cm3 versus 544 ± 159 cm3) and in the mean left portal flow index (1.1 ± 0.2 ml/minute/cm3 versus 0.69 ± 0.2 ml/minute/cm3) as measured before the subjects ate. After a meal, the portal blood‐flow volume in the right lobe was similar in the 2 groups but in the left lobe was significantly lower in the patients (p = 0.0009). The left postprandial portal flow index was inversely correlated with the grade of liver fibrosis (r = 0.533). Conclusions The left‐lobe volume (positive predictive value, 83%; negative predictive value, 72%) and left postprandial portal flow index (positive predictive value, 86%; negative predictive value, 88%) are sensitive indicators of chronic hepatitis. The left postprandial portal flow index may be a useful test for differentiating patients with minimal or no fibrosis from patients with mild to severe fibrosis. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:461–468, 2000.