Document Detail

Arterioportal fistulas in patients with liver cirrhosis: usefulness of color Doppler US for screening.
MedLine Citation:
PMID:  10966704     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To evaluate the usefulness of routine ultrasonographic (US) evaluation of the hepatic arterial resistive and pulsatility indexes and of the direction of portal venous blood flow for the diagnosis of intrahepatic arterioportal fistulas (APFs) in patients with liver cirrhosis. MATERIALS AND METHODS: In all patients with cirrhosis examined at one center over 4 years, the resistive (RI) and the pulsatility (PI) indexes in the right and left branches of the hepatic artery were evaluated with Doppler US. An APF was suspected when an RI decrease of at least 20% and a PI decrease of at least 30% were present in one hepatic lobe relative to values in the other lobe and portal blood flow in the lobe with the decreased values was reversed. The RI and PI in patients with an APF were compared with those in 75 patients with cirrhosis and without APFs at angiography. RESULTS: Seven patients with an APF were identified. APFs suspected at Doppler US were always confirmed with angiography. The percent differences +/- SD in the RI and the PI between the two intrahepatic branches of the hepatic artery in patients with versus in patients without an APF were as follows: RI, 35% +/- 6 (range, 27%-42%) versus 5% +/- 4 (range, 0%-15%) (P: <.001); PI, 50% +/- 5 (range, 41%-58%) versus 11% +/- 7 (range, 0%-26%) (P: <.001). CONCLUSION: The intrahepatic arterial resistive and pulsatility indexes and the direction of portal blood flow should be evaluated in routine screening for APFs in patients with liver cirrhosis.
M Bolognesi; D Sacerdoti; G Bombonato; M Chiesura-Corona; C Merkel; A Gatta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  216     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-09-19     Completed Date:  2000-09-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  738-43     Citation Subset:  AIM; IM    
Department of Clinical and Experimental Medicine, Clinica Medica 5, Policlinico Universitario, Padova, Italy.
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MeSH Terms
Arteriovenous Fistula / ultrasonography*
Hepatic Artery / ultrasonography*
Liver Cirrhosis / ultrasonography*
Mass Screening*
Middle Aged
Portal Vein / ultrasonography*
Pulsatile Flow / physiology
Sensitivity and Specificity
Ultrasonography, Doppler, Color*
Vascular Resistance / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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