Performance of Doppler ultrasound in the prediction of severe portal hypertension in hepatitis C virus-related chronic liver disease

Purpose: To evaluate the correlation between hepatic vein pressure gradient measurement and Doppler ultrasonography (DUS) in patients with chronic liver disease (CLD). Patients and methods: Sixty-six patients with fibrotic to cirrhotic hepatitis C virus-related CLD, were consecutively included upon referral to our haemodynamic laboratory. Superior mesenteric artery pulsatility index (SMA-PI), right interlobar renal and intraparenchymal splenic artery resistance indices, were determined, followed by hepatic venous pressure gradient (HVPG) measurement. Results: A correlation was found between HVPG and intraparenchymal splenic artery resistance index (SA-RI) (r=0.50, P < 0.0001), SMA-PI (r=-0,48, P < 0.0001), right interlobar renal artery resistance index (RRA-RI) (r=0.51, P < 0.0001) in the whole patient population. However, dividing patients according to the presence/absence of severe portal hypertension (i.e. HVPG >= 12 mmHg), a correlation between HVPG and intraparenchymal SA-RI (r=0.70, P < 0.0001), SMA-PI (r=-0.49, P=0.02), RRA-RI (r=0.66, P=0.0002) was observed only for HVPG values < 12 mmHg. HVPG but not DUS correlated with the presence of esophageal varices (P < 0.0001). Conclusions: Superior mesenteric artery pulsatility index, intraparenchymal splenic and right interlobar renal artery resistance indices do not adequately predict severe portal hypertension.