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DOI: 10.1148/radiol.2402051142
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Recent Variceal Bleeding: Doppler US Hepatic Vein Waveform in Assessment of Severity of Portal Hypertension and Vasoactive Drug Response1

Soon Koo Baik, MD, PhD, Jae Woo Kim, MD, Hyun Soo Kim, MD, PhD, Sang Ok Kwon, MD, PhD, Young Ju Kim, MD, Joong Wha Park, MD, Seong Hyun Kim, MD, Sei Jin Chang, PhD, Dong Ki Lee, MD, PhD, Kwang Hyub Han, MD, PhD, Soon Ho Um, MD, PhD and Samuel S. Lee, MD, FRCPC

1 From the Departments of Internal Medicine (S.K.B., J.W.K., H.S.K., S.O.K.), Radiology (Y.J.K., J.W.P., S.H.K.), and Preventive Medicine (S.J.C.), Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju 220-701, South Korea; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea (D.K.L., K.H.H.); Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea (S.H.U.); and Liver Unit, University of Calgary, Calgary, Alberta, Canada (S.S.L.). Received July 7, 2005; revision requested September 8; revision received September 21; accepted October 18; final version accepted November 23. Supported by the Ministry of Health and Welfare, Republic of Korea (grant A050021) and the Clinical Research Fund of the Korean Association for the Study of the Liver (unencumbered grant from GlaxoSmithKline Korea). S.S.L. supported by an Alberta Heritage Foundation for Medical Research Senior Scholarship award. Address correspondence to S.K.B. (e-mail: baiksk{at}medimail.co.kr).


Figure 1
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  		Figure 1: A combination of schematic drawings and US Doppler waveforms shows classification of hepatic vein Doppler waveforms.

 

Figure 2
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  		Figure 2: Graph shows distribution of hepatic vein waveform types according to the HVPG.

 

Figure 3
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  		Figure 3: US images show change in hepatic vein waveform (a) before and (b) 20 minutes after terlipressin administration in a patient with Child-Pugh class B disease. The hepatic vein waveform changed from a monophasic to a biphasic waveform concomitant with a decrease in HVPG from 18 to 9 mm Hg.

 

Figure 4
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  		Figure 4: US images show change in hepatic vein waveform (a) before and (b) 20 minutes after terlipressin administration in a patient with Child-Pugh class A disease. Phasic oscillation decreased and biphasic waveform amplitude improved in association with an HVPG decrease from 11 to 7 mm Hg.

 




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