The Detection Of Hemodynamics In The Portal Vien And The Splenic Vein In Patients With Liver Cirrhosis By Color Doppler Flow Imaging Clinically

Objective:1 This study was designded to evaluate the relationship between the changes of hemodynamics in portal vien and splenic vien in 81 cases with cirrehosis and the degree of correhosis by ultrasound scanning for the groups divided according to Child-Pugh method So as to provide the reliable datas for the diagnosis and to eveluate the therapy clinically.2 To document the changes of the portal congestion index. Ipv(Ipv=S/V)in groups divided according to Child-Pugh method(A,B,C)and measure the Ipv in B or less than B when the liver function decreased and find out the critical value of the the Ipv. To eveluate the sensitivity, specificity and accuracy of. the threshold so as to provie the reliable datas for early treatment clinically.Methods:1 Cases and groups:(1)Control group:22 healthy adults(male 17cases and female 5 cases) . There was no any history of liver disease and others and abnormal liver function recently. The HBV markers was negative. (2) Study Groups:The 81 cases were diagnosed as cirrhosis clinically after type C hepatitis. Child–Pugh : A-25 cases(male 18cases and female 7 cases); B -26 cases(male 19cases and female 7 cases);C-30 cases(male 21cases and female 9 cases).2 Equipment and instrument: Phillips IU-22 with 2-5MHZ inear-array trans- ducer. Sampling volume was1-6mm. The standard abdominal blood flow model was setted. The gain was large enough to be no noise appeared.3 Methods: The 81 cases of liver cirrhosis hospitalized patients were examed by ultrasound. The subjects fasted more than 8-12 hours before the exami- nation and maded the supine position. Detection of portal vein (PV) and splenic vein (SV) diameter (D) and velocity (V). Sampling volume was1-6mm. When measurring in the portal vein was from hilar confluence 1. 0 ~ 1. 5 cm. When measuring splenic vein measured in the spleen portal. traveling aligned vein (right angle) to detect blood vessel diameter. Each time when the same patient was measured. The blood sampling line was 60°beam angle of less than. The subjects should keep the inspiratory breath-hold position in the quiet breathing . Dpv. Dsv.Vpv.Vsv should were detected at least 3 to 5 cardiac cycles of the Doppler spectrum of the more stable. measuring at least 2 times. then averaged.4 Evaluation criteria: Based on the clinical well-known for everyone on the Child-Pugh: The liver function was divided into A.B.C III. Levels were measured in the portal vein and splenic hemodynamics changes. Ultrasound examination was by a senior and I maded.graduating physicians real-time dynamic ultrasound scanning. Averaging multiple measurements to reduce error, the final results were analyzed.5 Statistical analysis: All data entry strictly before proofreading. to establish a database with Excel. using SPSS13.0 statistical software for data processing, data with mean±standard deviation ( x±S). said the three study groups and control groups Group among the four groups compared by analysis of variance or nonparametric rank test. When P <0.05, the view that there was significant difference. when P <0.01. the view that there was significant statistical difference.Results:1 Portal vein and splenic vein's diameter of cirrhotic patients with the liver function A B C grade were gradually widen. a statistically significant was difference among levels (P<0.01). at all levels of the control group were significantly different ( P<0.01).2 Portal vein and splenic vein blood flow velocity with the increase of the Child-Pugh gradually slowed down. in which portal venous blood flow velocity A,B and C were significantly different between the three levels (P <0.01).levels were associated with the control group were significantly different (P<0.01). there was not significant change(P>0.05) between Splenic vein blood flow velocity A-level and the control group. C grade and B grade had no significant change (P>0.05); B level and A level,the control group were significantly different (P<0.01). C-level and A level. the control group were significantly different (P<0.01).3 Portal vein and splenic vein blood flow velocity gradually increased, hepatic portal blood flow did not change significantly among A,B,C levels (P> 0.05). but increased significantly than the control group; splenic blood flow between levels statistically was significantly different (P<0.01). all levels were significantly different with the control group (P<0.01).4 The portal vein and splenic vein cross-sectional area A,B,C grades was gradually widened. the statistical difference between levels is significantly (P <0.01). all levels were significantly different with the control group (P<0.01).5 Qsv/Qpv ratio in the A,B,C grades is gradually increased, the statistical difference between levels is significantly (P<0.01). all levels were significantly different with the control group (P<0.01).6 Ipv (Ipv=S/V) in A,B,C grades gradually increased, the statistical difference between levels was significantly (P<0.01). all levels were significantly different with the control group (P<0.01).81 cases of the patients by Ipv <0.06. 0.06-0.11. > 0.11 were divided into three groups. respectively were compared with liver function. The results showed that 25 cases of A-group patients. 19 patients'Ipv <0.06. 6 patients'Ipv between in the 0.06-0.11; 26 cases of B-class group of patients. the 6 cases'Ipv<0.06. 7 cases'Ipv between 0.06-0.11. 13 cases'Ipv>0.11; 30 cases of C-class patients. 4 cases'Ipv <0.06,9 cases'Ipv between 0.06-0.11. 17 cases'Ipv>0.11; and 22 normal controls. 21 patients'Ipv<0.06. only 1 case between 0.06-0.11. If Ipv the cutoff value set at 0.06,then the tips of liver function in patients with cirrhosis decreased to or below B-class sensitivity. specificity and accuracy were 84%,76% and 75.31%. Conclusion:1 Doppler ultrasound exam the portal vein and splenic vein blood flow changes in the relationship between the severity of liver cirrhosis. and provide some help for clinicaldiagnosis and treatment evaluation to liver cirrhosis.2 Ultrasonography with painless,non-invasive,repeatable,low cost and other advantages is a reliable noninvasive means of imaging diagnosis.