Correlation between hepatic wave form changes on doppler ultrasound and severity of disease in cirrhotic patients

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.