Renovascular Impedance Correlates with Portal Pressure in Patients with Liver Cirrhosis
| Autor: | Marco Zoli, Annalisa Berzigotti, Cristina Rossi, Francesco Losinno, Andrea Casadei, Donatella Magalotti, Nicola Castaldini |
|---|---|
| Přispěvatelé: | Berzigotti A., Casadei A., Magalotti D., Castaldini N., Losinno F., Rossi C., Zoli M. |
| Rok vydání: | 2006 |
| Předmět: |
ECO-DOPPLER
Adult Liver Cirrhosis Male medicine.medical_specialty Cirrhosis IPERTENSIONE PORTALE Portal venous pressure Esophageal and Gastric Varices Sensitivity and Specificity Severity of Illness Index Esophageal varices RESISTENZE RENOVASCOLARI Predictive Value of Tests medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Ultrasonography Doppler Color Prospective cohort study Aged business.industry Middle Aged CIRROSI EPATICA medicine.disease Institutional review board Portal Pressure Catheter Hypertension Renovascular medicine.anatomical_structure Ultrasonography Doppler Pulsed Predictive value of tests Vascular resistance Female Vascular Resistance Radiology business CATETERISMO VENE SOVRAEPATICHE |
| Zdroj: | Radiology. 240:581-586 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2401050585 |
| Popis: | To prospectively evaluate, in patients with liver cirrhosis, the correlation between the renovascular impedance measured by using color flow and pulsed wave Doppler ultrasonography (US) and the portal pressure measured by using the hepatic venous pressure gradient (HVPG).The study was approved by the senior staff committee (comparable to institutional review board) of the university hospital, and written informed consent was obtained from all patients. Thirty-one patients with cirrhosis (22 men, nine women; mean age, 57.6 years +/- 8.8 [standard deviation]) and esophageal varices were consecutively enrolled in the study. Having fasted, the patients underwent color flow and pulsed wave Doppler US of the right interlobar renal artery (RRA) and the left interlobar renal artery (LRA). The resistance index (RI) and pulsatility index (PI) were determined. On the same day, with fluoroscopic guidance, a 5-F balloon-tipped catheter was advanced, via the right basilic vein, into the right hepatic vein; HVPG was calculated as the difference between the wedged and free hepatic pressures. All measurements were performed in triplicate, and permanent tracings were recorded. Correlations were made by using the Pearson test. The positive predictive value of renovascular impedance for detection of severe portal hypertension was determined.Mean RI and PI values were 0.67 +/- 0.07 and 1.21 +/- 0.25, respectively, for the RRA, and 0.68 +/- 0.07 and 1.24 +/- 0.26, respectively, for the LRA. All patients had portal hypertension (mean HVPG, 19.3 mm Hg +/- 4.7; range, 11.5-33.5 mm Hg). Neither portal pressure nor renal impedance correlated with Child-Pugh score for cirrhosis. Renal artery impedance indexes correlated with the HVPG (for RRA RI: R = 0.424, P = .03; for RRA PI: R = 0.402, P = .04; for LRA RI: R = 0.352, P = .05; for LRA PI: R = 0.393, P = .02). A higher-than-normal renal impedance had a high positive predictive value (RRA RI and PI, 100%; LRA RI, 92%; LRA PI, 84%) for the detection of severe portal hypertension.Renovascular impedance had a direct correlation with HVPG. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|