Radiology, Vol 207, 711-715, Copyright © 1998 by Radiological Society of North America
Doppler sonography of the portal vein and hepatic artery: measurement of a prandial effect in healthy subjects
AJ Fisher, EK Paulson, MA Kliewer, DM DeLong and RC Nelson
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
PURPOSE: To determine if the prandial effect outweighs variability in the
measurement of portal venous blood flow and hepatic arterial resistive
index. MATERIALS AND METHODS: Fourteen healthy adult volunteers fasted
overnight. For eight of the subjects, two sonographers performed three
determinations of portal venous blood flow and hepatic arterial resistive
index before and 30 minutes after a liquid meal (5 mg per kilogram of body
weight). In the remaining six volunteers, determinations were made at the
same time intervals but without a meal. The sonographers were blinded to
on-screen measurements and the subject's prandial status. RESULTS: For
subjects examined after the meal by sonographers A and B, respectively,
portal venous blood flow increased from 144.2 to 201.7 mL/min and from
209.2 to 331.9 mL/min and hepatic arterial resistive index increased from
0.70 to 0.77 and from 0.67 to 0.78. After repeated-measures analysis of
variance, ingestion of a meal was estimated to increase portal venous blood
flow by 96.3 mL/min (P < .001)--a change in sonographers could affect
the measurement by 76.7 mL/min (P < .001)--and to increase hepatic
arterial resistive index by 0.089 (P < .001)--a change in sonographers
did not affect the measurement (P > .1). CONCLUSION: The prandial effect
on portal venous blood flow is only marginally greater than the
interobserver variation in the measurement. Hepatic arterial resistive
index also increases after a meal, but interobserver differences between
sonographers are minimal; therefore, it is a more robust measurement.
