Doppler Analysis of Hepatic Venous Waveforms: A Reliable Way to Diagnose and Guess the Size of Esophageal Varices in People with Cirrhosis of the Liver

Abstract

Objective: To determine the diagnostic accuracy of Doppler assessment of hepatic venous waveforms for predicting large esophageal varices in patients with cirrhosis, keeping esophagogastroduodenoscopy as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Radiology & Imaging, Rawalpindi Pakistan, from Jan 2021 to Jan 2022. Methodology: According to the Child-Pugh classification, 157 cases of liver cirrhosis were included in this study. With a convex probe operating at 3.5 to 5 MHz, a Doppler ultrasound was executed. If quiet breathing wasn't an option, the spectral waveform was captured at the end of the inhalation phase while holding your breath. This was roughly 3–6 cm from where it connects to the inferior vena cava. All patients underwent an esophagogastroduodenoscopy. Results: In Doppler USG-positive patients, 84 (true positive) developed significant esophageal varices on endoscopy, while 4 (false positive) did not. Among 69 individuals with negative Doppler USG results, six (false negative) had significant esophageal varices on endoscopy, whereas 63 (true negative) did not (p=0.0001). We found that the overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of Doppler evaluation of hepatic venous waveforms were 93.33%, 94.0%, 95.45%, 91.30%, and 93.6% for finding large esophageal varices in cirrhotic patients using esophagogastroduodenoscopy as the gold standard. Conclusion: This study proved that using Doppler to look at hepatic vein waveforms is a very sensitive and accurate noninvasive way to tell if someone with cirrhosis will get big esophageal varices.

Keywords

• Esophageal varices
• Hepatic vein waveforms
• Liver cirrhosis