Jonas Valantinas

Clinic of Gastroenterology and Dietetics, Vilnius University Faculty of Medicine

Key words: liver cirhosis, portal vein, portal hypertension, sonography.

Summary. Portal venous flow velocity was measured with duplex Doppler equipment in 29 normal subjects and in 155 patients patients with chronic liver disease who shoved evidence of advanced liver damage such as ascites, hepatic encephalopathy, oesophageal varices etc. Third group consists of 27 patients suffering from different mieloproliferative disease and hepatosplenomegaly with or without ascites.

The aim of this study was to evaluate measurements of portal flow velocity and portal venous congestion index in patients suffering from liver cirrhosis and different mieloproliferative disease.

The abdominal ultrasonography was performed with digital ultrasound machine with colour Doppler imaging capability Logiq 500. Pulse wave Doppler flow analysis in the trunk of portal vein was performed using Doppler gate 3-5 mm and Doppler angle approximate to 60 degrees.

In healthy individuals the average speed of blood flow in portal vein was 39.99±13.2 cm/sec. In the case of liver cirrhosis – 23.12±9.7 cm/sec., in cases of mieloproliferative diseases – 41.86±17.6 cm/sec. Those changes are statistically reliable and do not completely correlate with the diameter of portal vein. Blood flow decreasment occurs in the case of complicated liver cirrhosis. Changes in portal haemodynamics in the presence of ascites were statistically significant, but they were not considerably bigger than in the presence of other complications.

Portal venous blood flow and congestion index in patients suffering from blood diseases are very close to normal values and may be used to differentiate causes of prehepatic portal hypertension. Blood flow speed decreasement and increasement of congestion index in trunk of portal vein reliably correlates with portal hypertension and its complications. Localisation of portosystemic shunts and splenomegaly do not substantially influence portal trunk blood flow speed and congestion index.