Simultaneous Doppler measurement of portal venous peak velocity, hepatic arterial peak velocity, and splenic arterial pulsatility index for assessment of hepatic circulation

Background/Aims: Quantitative Doppler assessment of hepatic circulation is widely performed in patients with cirrhosis. Since few studies have attempted to evaluate the various parameters simultaneously, we sought to examine the applicability and possible advantages of such simultaneous measurement for assessment of hepatic function. Methodology: In 64 patients (21 with cirrhosis, 17 with chronic hepatitis, and 26 with no liver disorder) we prospectively performed Doppler measurement of right portal venous peak velocity (PVPV), right hepatic arterial peak systolic velocity (HAPSV) and splenic arterial pulsatility index (SAPI) and calculated a novel parameter, the hepatic circulatory index (HCI). The HCI was calculated using the formula: HCI (cm(2)/s(2)) = PVPV (cm/s) x HAPSV (cm/s)/ SAPI. Results: Not every Doppler parameter was useful in itself for quantitative assessment of liver function. On the other hand, hepatic circulatory index was significantly higher in controls (1275.1 +/- 297.5) than in patients with hepatitis (931.7 +/- 270.5, P = 0.0003), or cirrhosis (586.4 +/- 264.9, P < 0.0001) and was highly correlated with the plasma clearance rate of indocyanine green (KICG; r = 0.848, P < 0.001). Conclusions: Hepatic circulatory index was correlated with KICG, which reflects hepatic circulation. The hepatic circulatory index is a novel parameter of hepatic circulation that can be measured easily at bedside, accurately reflecting hepatic circulatory status.