Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients
Background/Aim: Color Doppler examination of changes in hepatic venous waveforms is being evaluated as a means of prediction of severity of portal hypertension and presence of esophageal varices. Normal hepatic venous waveform shows a triphasic pattern. In cirrhosis, this pattern changes to a biphas...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2011-01-01
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| Series: | The Saudi Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2011;volume=17;issue=1;spage=36;epage=39;aulast=Joseph |
| _version_ | 1818213348850794496 |
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| author | Thomas Joseph Mukunda Madhavan Krishnadas Devadas Vinayakumar K Ramakrishnannair |
| author_facet | Thomas Joseph Mukunda Madhavan Krishnadas Devadas Vinayakumar K Ramakrishnannair |
| author_sort | Thomas Joseph |
| collection | DOAJ |
| description | Background/Aim: Color Doppler examination of changes in hepatic venous waveforms is being evaluated as a means of prediction of severity of portal hypertension and presence of esophageal varices. Normal hepatic venous waveform shows a triphasic pattern. In cirrhosis, this pattern changes to a biphasic or monophasic pattern. We aimed to study the sensitivity of loss of normal hepatic venous waveforms in predicting large varices in a cross-sectional analysis. Materials and Methods: All patients, admitted or attending the outpatient department, with a diagnosis of cirrhosis were included in the study. All patients were subjected to oesophagogastroduodenoscopy and Color Doppler examination, and waveform patterns in hepatic vein were recorded. The sensitivity and specificity of changes in waveform in detecting large varices were studied. Results : A total of 51 cases were examined. Triphasic waves were seen in 4 (7.8%) cases, biphasic in 26 (51%) cases, and monophasic in 21 (41.2%) cases. Small varices were seen in 30 (58.8%) cases and large varices in 21 (41.2%) cases. The sensitivity of loss of the triphasic wave pattern in detecting significant varices (Grade 3 or 4) was very high (95.23%) and negative predictive value was also high (75%). Severity of liver disease as indicated by Child-Pugh and MELD scores did not correlate with changes in hepatic venous waveforms. Conclusion : Loss of triphasic hepatic venous waveform is highly sensitive in predicting significant varices in patients with cirrhosis. |
| first_indexed | 2024-12-12T06:02:52Z |
| format | Article |
| id | doaj.art-258605f2f399439a83abb61e1cdea8b3 |
| institution | Directory Open Access Journal |
| issn | 1319-3767 1998-4049 |
| language | English |
| last_indexed | 2024-12-12T06:02:52Z |
| publishDate | 2011-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj.art-258605f2f399439a83abb61e1cdea8b32022-12-22T00:35:20ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492011-01-01171363910.4103/1319-3767.74465Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patientsThomas JosephMukunda MadhavanKrishnadas DevadasVinayakumar K RamakrishnannairBackground/Aim: Color Doppler examination of changes in hepatic venous waveforms is being evaluated as a means of prediction of severity of portal hypertension and presence of esophageal varices. Normal hepatic venous waveform shows a triphasic pattern. In cirrhosis, this pattern changes to a biphasic or monophasic pattern. We aimed to study the sensitivity of loss of normal hepatic venous waveforms in predicting large varices in a cross-sectional analysis. Materials and Methods: All patients, admitted or attending the outpatient department, with a diagnosis of cirrhosis were included in the study. All patients were subjected to oesophagogastroduodenoscopy and Color Doppler examination, and waveform patterns in hepatic vein were recorded. The sensitivity and specificity of changes in waveform in detecting large varices were studied. Results : A total of 51 cases were examined. Triphasic waves were seen in 4 (7.8%) cases, biphasic in 26 (51%) cases, and monophasic in 21 (41.2%) cases. Small varices were seen in 30 (58.8%) cases and large varices in 21 (41.2%) cases. The sensitivity of loss of the triphasic wave pattern in detecting significant varices (Grade 3 or 4) was very high (95.23%) and negative predictive value was also high (75%). Severity of liver disease as indicated by Child-Pugh and MELD scores did not correlate with changes in hepatic venous waveforms. Conclusion : Loss of triphasic hepatic venous waveform is highly sensitive in predicting significant varices in patients with cirrhosis.http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2011;volume=17;issue=1;spage=36;epage=39;aulast=JosephDopplerhepatic venous waveformvarices |
| spellingShingle | Thomas Joseph Mukunda Madhavan Krishnadas Devadas Vinayakumar K Ramakrishnannair Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients The Saudi Journal of Gastroenterology Doppler hepatic venous waveform varices |
| title | Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients |
| title_full | Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients |
| title_fullStr | Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients |
| title_full_unstemmed | Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients |
| title_short | Doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients |
| title_sort | doppler assessment of hepatic venous waves for predicting large varices in cirrhotic patients |
| topic | Doppler hepatic venous waveform varices |
| url | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2011;volume=17;issue=1;spage=36;epage=39;aulast=Joseph |
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