HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2401050585v1 240/2/581    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Berzigotti, A. Articles by Zoli, M. Search for Related Content PubMed PubMed Citation Articles by Berzigotti, A. Articles by Zoli, M.

Renovascular Impedance Correlates with Portal Pressure in Patients with Liver Cirrhosis¹

¹ From Dipartimento di Medicina Interna, Cardioangiologia, Epatologia (A.B., D.M., N.C., M.Z.) and Dipartimento Clinico di Scienze Radiologiche ed Istocitopatologiche (A.C., F.L., C.R.), Università di Bologna, Policlinico S. Orsola-Malpighi, via Albertoni 15-40138 Bologna, Italy. Received April 8, 2005; revision requested June 10; revision received June 23; accepted July 19; final version accepted September 22. Supported in part by a grant from the Ministero dell'Università e della Ricerca Scientifica e Tecnologica (MURST)-Progetti di Ricerca di Interesse nazionale (Fondi ex-40%). Address correspondence to M.Z. (e-mail: marco.zoli{at}unibo.it).

Purpose: To prospectively evaluate, in patients with liver cirrhosis, the correlation between the renovascular impedance measured by using color flow and pulsed wave Doppler ultrasonography (US) and the portal pressure measured by using the hepatic venous pressure gradient (HVPG).

Materials and Methods: The study was approved by the senior staff committee (comparable to institutional review board) of the university hospital, and written informed consent was obtained from all patients. Thirty-one patients with cirrhosis (22 men, nine women; mean age, 57.6 years ± 8.8 [standard deviation]) and esophageal varices were consecutively enrolled in the study. Having fasted, the patients underwent color flow and pulsed wave Doppler US of the right interlobar renal artery (RRA) and the left interlobar renal artery (LRA). The resistance index (RI) and pulsatility index (PI) were determined. On the same day, with fluoroscopic guidance, a 5-F balloon-tipped catheter was advanced, via the right basilic vein, into the right hepatic vein; HVPG was calculated as the difference between the wedged and free hepatic pressures. All measurements were performed in triplicate, and permanent tracings were recorded. Correlations were made by using the Pearson test. The positive predictive value of renovascular impedance for detection of severe portal hypertension was determined.

Results: Mean RI and PI values were 0.67 ± 0.07 and 1.21 ± 0.25, respectively, for the RRA, and 0.68 ± 0.07 and 1.24 ± 0.26, respectively, for the LRA. All patients had portal hypertension (mean HVPG, 19.3 mm Hg ± 4.7; range, 11.5–33.5 mm Hg). Neither portal pressure nor renal impedance correlated with Child-Pugh score for cirrhosis. Renal artery impedance indexes correlated with the HVPG (for RRA RI: R = 0.424, P = .03; for RRA PI: R = 0.402, P = .04; for LRA RI: R = 0.352, P = .05; for LRA PI: R = 0.393, P = .02). A higher-than-normal renal impedance had a high positive predictive value (RRA RI and PI, 100%; LRA RI, 92%; LRA PI, 84%) for the detection of severe portal hypertension.

Conclusion: Renovascular impedance had a direct correlation with HVPG.

© RSNA, 2006