Display options
Share it on

Ann Gastroenterol. 2015 Apr-Jun;28(2):271-275.

Hepatic artery duplex Doppler ultrasound in severe alcoholic hepatitis and correlation with Maddrey's discriminant function.

Annals of gastroenterology

Haridas Abhilash, Madhavan Mukunda, Premaletha Sunil, Krishnadas Devadas, Katoor Ramakrishnan Nair Vinayakumar

Affiliations

  1. Government Medical College, Thiruvananthapuram, Kerala, India.

PMID: 25830566 PMCID: PMC4367219

Abstract

BACKGROUND: Alcoholic hepatitis is associated with altered hepatic artery hemodynamics. Maddrey's discriminant function (MDF) can identify patients with poor prognosis (DF >32). We studied hepatic artery hemodynamic parameters of hepatic artery diameter (HAD), resistive index (RI) and pulsatility index (PI) in severe acute alcoholic hepatitis (SAAH) and for the presence of correlation of parameters with severity factor MDF.

METHODS: A total of 20 consecutive SAAH patients defined as MDF >32 and a group of 20 alcoholic cirrhosis patients without alcoholic hepatitis formed the two study groups. Hepatic artery Doppler parameters HAD, RI, PI were determined after admission in the Gastroenterology Department, Government Medical College, Thiruvananthapuram, India. MDF score of SAAH was calculated at the time of admission to the hospital.

RESULTS: The mean HAD showed statistically significant increase in SAAH compared with cirrhosis (3.96±0.51 vs. 2.86±0.41, P<0.001). There was statistically significant decrease in mean RI (0.49±0.08 vs. 0.81±0.09, P<0.001) and mean PI (1.67±0.13 vs. 1.80±0.13, P<0.001) in SAAH compared with alcoholic cirrhosis. Statistically significant correlation between MDF and HAD (r=0.63, P<0.003) was found in SAAH. On linear regression, 36% of the variability in MDF could be independently predicted by HAD.

CONCLUSION: Hepatic artery parameters of HAD, RI, PI had a significant difference in SAAH compared with alcoholic cirrhosis patients thereby being useful as a diagnostic tool. HAD showed correlation with MDF score assessing the severity of alcoholic hepatitis and may be a useful non-invasive prognostic tool.

Keywords: Alcoholic hepatitis; Maddrey’s discriminant function; duplex Doppler ultrasound; hepatic artery

References

  1. Med Eng Phys. 2013 Aug;35(8):1053-8 - PubMed
  2. N Engl J Med. 2009 Jun 25;360(26):2758-69 - PubMed
  3. Hepatology. 1998 Nov;28(5):1182-6 - PubMed
  4. JAMA. 1968 Dec 9;206(11):2518-20 - PubMed
  5. Hepatogastroenterology. 1996 Mar-Apr;43(8):427-31 - PubMed
  6. World J Gastroenterol. 2010 Dec 28;16(48):6046-57 - PubMed
  7. AJR Am J Roentgenol. 1992 Nov;159(5):943-50 - PubMed
  8. J Clin Gastroenterol. 2002 May-Jun;34(5):573-7 - PubMed
  9. Surg Today. 1999;29(1):1-9 - PubMed
  10. Hepatology. 2004 Dec;40(6):1370-8 - PubMed
  11. Hepatol Res. 2007 Nov;37(11):891-903 - PubMed
  12. Exp Clin Transplant. 2012 Aug;10(4):356-62 - PubMed
  13. Z Gastroenterol. 2002 Jan;40(1):21-32 - PubMed
  14. AJR Am J Roentgenol. 1985 Jul;145(1):57-61 - PubMed
  15. Gastroenterology. 1993 Nov;105(5):1477-82 - PubMed
  16. Circ Shock. 1986;18(4):267-75 - PubMed
  17. Radiology. 1968 Aug;91(2):290-6 - PubMed
  18. Gastroenterology. 2011 Nov;141(5):1572-85 - PubMed
  19. J Clin Invest. 1973 Nov;52(11):2952-62 - PubMed
  20. Crit Care Med. 1993 Feb;21(2 Suppl):S19-24 - PubMed
  21. Gastroenterology. 1978 Aug;75(2):193-9 - PubMed

Publication Types