Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension

BACKGROUND & AIMS: Hepatic blood flow (HBF) is best estimated by the Fick's method during indocyanine green constant infusion (ICG-HBF) on hepatic vein catheterization. We investigated the consistency and agreement of HBF measured by Doppler ultrasound (US-HBF) as compared with ICG-HBF in p...

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Autores: Berzigotti, Annalisa, Reverter, Enric, García-Criado, Angeles, González-Abraldes Iglesias, Juan, Cerini, Federica, García Pagán, Juan Carlos, Bosch i Genover, Jaume
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2013
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/59884
Acceso en línea:https://hdl.handle.net/2445/59884
Access Level:acceso abierto
Palabra clave:Hipertensió portal
Cirrosi hepàtica
Ecografia Doppler
Portal hypertension
Hepatic cirrhosis
Doppler ultrasonography
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spelling Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertensionBerzigotti, AnnalisaReverter, EnricGarcía-Criado, AngelesGonzález-Abraldes Iglesias, JuanCerini, FedericaGarcía Pagán, Juan CarlosBosch i Genover, JaumeHipertensió portalCirrosi hepàticaEcografia DopplerPortal hypertensionHepatic cirrhosisDoppler ultrasonographyBACKGROUND & AIMS: Hepatic blood flow (HBF) is best estimated by the Fick's method during indocyanine green constant infusion (ICG-HBF) on hepatic vein catheterization. We investigated the consistency and agreement of HBF measured by Doppler ultrasound (US-HBF) as compared with ICG-HBF in portal hypertensive patients with cirrhosis. METHODS: In 50 patients observed for HVPG measurement (56% compensated; Child score 7 ± 2; HVPG 16.6 ± 6.0 mmHg; varices in 75%) US-HBF (Sequoia-512-Acuson; 4.5-7 MHz convex probe; US-HBF = hepatic artery blood flow+portal vein blood flow) and ICG-HBF (Fick's method after an equilibration period of at least 45 min of ICG bolus of 5 mg + constant rate infusion of 0.2 mg/min). Intraclass correlation coefficient (ICC) for consistency and absolute agreement between US-HBF and ICG-HBF were calculated. RESULTS: Mean ICG-HBF and US-HBF were similar, being respectively 1004 ± 543 ml/min and 994 ± 494 ml/min (p = 0.661 vs. ICG-HBF). However, results in individual patients disclosed marked differences between the two methods (386 ± 415 ml/min) and showed only moderate consistency (ICC 0.456; p < 0.0001), absolute agreement (ICC 0.461; p < 0.0001) and linear correlation (R = 0.464; p < 0.0001). The discrepancy between the two methods was maximal in patients with poor liver function, high HBF by any technique and more arterialized liver circulation. Hepatic artery blood flow ≥40% of US-HBF indicated, with 90% specificity, a discrepancy ≥20% between US-HBF and ICG-HBF. CONCLUSIONS: HBF estimations by Doppler-ultrasound and ICG are significantly correlated, but their discrepancy in individual cases is high. Estimation of HBF by Doppler-US should be considered unreliable in patients with poor hepatic function and large liver arterialization.Elsevier2013info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/59884Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: http:/dx.doi.org/10.1016/j.jhep.2013.04.037Journal of Hepatology, 2013, vol. 59, num. 4, p. 717-722http://dx.doi.org/10.1016/j.jhep.2013.04.037(c) Elsevier, 2013info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/598842026-05-27T06:46:51Z
dc.title.none.fl_str_mv Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
title Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
spellingShingle Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
Berzigotti, Annalisa
Hipertensió portal
Cirrosi hepàtica
Ecografia Doppler
Portal hypertension
Hepatic cirrhosis
Doppler ultrasonography
title_short Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
title_full Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
title_fullStr Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
title_full_unstemmed Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
title_sort Reliability of the estimation of total hepatic blood flow by doppler ultrasound in patients with cirrhotic portal hypertension
dc.creator.none.fl_str_mv Berzigotti, Annalisa
Reverter, Enric
García-Criado, Angeles
González-Abraldes Iglesias, Juan
Cerini, Federica
García Pagán, Juan Carlos
Bosch i Genover, Jaume
author Berzigotti, Annalisa
author_facet Berzigotti, Annalisa
Reverter, Enric
García-Criado, Angeles
González-Abraldes Iglesias, Juan
Cerini, Federica
García Pagán, Juan Carlos
Bosch i Genover, Jaume
author_role author
author2 Reverter, Enric
García-Criado, Angeles
González-Abraldes Iglesias, Juan
Cerini, Federica
García Pagán, Juan Carlos
Bosch i Genover, Jaume
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Hipertensió portal
Cirrosi hepàtica
Ecografia Doppler
Portal hypertension
Hepatic cirrhosis
Doppler ultrasonography
topic Hipertensió portal
Cirrosi hepàtica
Ecografia Doppler
Portal hypertension
Hepatic cirrhosis
Doppler ultrasonography
description BACKGROUND & AIMS: Hepatic blood flow (HBF) is best estimated by the Fick's method during indocyanine green constant infusion (ICG-HBF) on hepatic vein catheterization. We investigated the consistency and agreement of HBF measured by Doppler ultrasound (US-HBF) as compared with ICG-HBF in portal hypertensive patients with cirrhosis. METHODS: In 50 patients observed for HVPG measurement (56% compensated; Child score 7 ± 2; HVPG 16.6 ± 6.0 mmHg; varices in 75%) US-HBF (Sequoia-512-Acuson; 4.5-7 MHz convex probe; US-HBF = hepatic artery blood flow+portal vein blood flow) and ICG-HBF (Fick's method after an equilibration period of at least 45 min of ICG bolus of 5 mg + constant rate infusion of 0.2 mg/min). Intraclass correlation coefficient (ICC) for consistency and absolute agreement between US-HBF and ICG-HBF were calculated. RESULTS: Mean ICG-HBF and US-HBF were similar, being respectively 1004 ± 543 ml/min and 994 ± 494 ml/min (p = 0.661 vs. ICG-HBF). However, results in individual patients disclosed marked differences between the two methods (386 ± 415 ml/min) and showed only moderate consistency (ICC 0.456; p < 0.0001), absolute agreement (ICC 0.461; p < 0.0001) and linear correlation (R = 0.464; p < 0.0001). The discrepancy between the two methods was maximal in patients with poor liver function, high HBF by any technique and more arterialized liver circulation. Hepatic artery blood flow ≥40% of US-HBF indicated, with 90% specificity, a discrepancy ≥20% between US-HBF and ICG-HBF. CONCLUSIONS: HBF estimations by Doppler-ultrasound and ICG are significantly correlated, but their discrepancy in individual cases is high. Estimation of HBF by Doppler-US should be considered unreliable in patients with poor hepatic function and large liver arterialization.
publishDate 2013
dc.date.none.fl_str_mv 2013
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/59884
url https://hdl.handle.net/2445/59884
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: http:/dx.doi.org/10.1016/j.jhep.2013.04.037
Journal of Hepatology, 2013, vol. 59, num. 4, p. 717-722
http://dx.doi.org/10.1016/j.jhep.2013.04.037
dc.rights.none.fl_str_mv (c) Elsevier, 2013
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Elsevier, 2013
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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