Clinic Study On The Relationship Between Hepatic Arteriovenous Transit Time And Hepatic Venous Pressure Gradient

Objective:to investigate the methods of measuring hepatic artery arrival time (HAAT),hepatic vein arrival time (HVAT) and hepatic arteriovenous transit time (HA-VTT) by contrast enhanced ultrasonography (CEUS) and discuss the relationship between HA-VTT and HVPG (hepatic pressure gradient)Methods:according to the liver function,sixty-five patients with liver cirrhosis were divided into two groups:compensatd cirrhotic patiens group and decompensatd cirrhrotic patiens group.The control group include twenty healthy persons without liver desease histroy.All of the sixty-five crrihrotic patients were measured both HA-VTT and HVPG,and the twenty persons in control group were only measured HA-VTT.And then analyzed the relationship between the two parameters statistically.Result:the cirrhotic patients had the HVPG and HA-VTT values of12.40±6.64mmHg (mean±SD;range1.5-33.1mmHg) and7.42±1.99sec (range4-13sec) respectively.the control group had HA-VTT value of13.25±2.10sec.The HAA-VTT value of cirrhotic patiens group was shorter than that of the control group (7.42±1.99vs13.25±2.10,t=11.315,p<o.001).there was a statistically significan negative correlation between HVPG and HA-VTT in the cirrhotic patients group (r=-0.826,p<0.01),and in the conpensated cirrhotic group (r=-0.872,p<0.01),and also in the deconpensaed cirrhotic patients group (r=-0.763,p<0.01).The area under the receiver operrating characteristic curve (AUROC) was0.894for clinically significant PHT (CSPH,HVPG>10mmHg),and the sensitivity,specificty for CSPH for an HA-VTT cut-off value of7.5sec were82.4%and86.9%,respectively.Conclusion:hepatic arteriovenous transit time is strongly correlated with the degree of hepatic venous pressure gradient;a hepatic arteriovenous transit time of<7.5sec can be used to discrimilate clinical significant portal hypertension with good sensitivity and specificity in compensated cirrhotic patients;measurement of hepatic venous pressure gradient is a potential noninvasive alternative methd for the assessment of the severity of portal hypertension.