Abstract:
Background: Liver cirrhosis represents the end-stage of various chronic liver diseases
characterized by progressive fibrosis and hemodynamic alterations. Doppler ultrasonography
offers a non-invasive method to assess these vascular changes through hepatic vein waveform
patterns. This study aimed to evaluate the correlation between hepatic vein waveform
changes and disease severity in cirrhotic patients and determine its diagnostic utility.
Methods: This prospective study included 140 patients with established liver cirrhosis who
underwent Doppler ultrasound examination of hepatic veins. Waveform patterns were
classified as triphasic, biphasic, or monophasic and correlated with Child-Pugh classification
and clinical-laboratory parameters. Statistical analysis was performed to evaluate associations
and diagnostic performance.
Results: The study population comprised 59.3% males and 40.7% females, with 45% of
patients in the 41-60 years age group. Child-Pugh classification revealed 22.9% Class A, 25%
Class B, and 52.1% Class C patients. Hepatic vein waveforms were distributed as
monophasic (38.6%), biphasic (36.4%), and triphasic (25%). A highly significant association
(p<0.001) was found between waveform patterns and Child-Pugh classification, with 70.4%
of monophasic and 68.6% of biphasic waveforms occurring in Class C patients, while 57.1%
of triphasic waveforms were seen in Class A patients. A significant association (p=0.008)
was also observed between waveform patterns and patient age. Diagnostic performance
analysis showed 100% sensitivity and negative predictive value with 52.2% specificity and
69.5% positive predictive value.
Conclusion: Hepatic vein waveform assessment by Doppler ultrasound provides a reliable
non-invasive marker of disease severity in cirrhotic patients, showing excellent correlation
with Child-Pugh classification. The high sensitivity and negative predictive value make this a
valuable screening tool, particularly for ruling out advanced cirrhosis. Integration of hepatic
vein waveform assessment into routine ultrasound evaluation offers prognostic information
without increasing procedure complexity or cost.
