Portal vein Doppler study in evaluation of portal vein pulsatility pattern for assessing severity of cirrhotic patients with portal hypertension

Afrin Shahria; Nasim Sultana; Mahbuba Shirin; Mahmuda Monowara; Tania Sultana; Bipasha Mosharof

doi:10.18203/2349-3291.ijcp20260398

Authors

Afrin Shahria Department of Radiology and Imaging, Bangladesh Medical University (BMU), Dhaka, Bangladesh
Nasim Sultana Department of Radiology and Imaging, Bangladesh Medical University (BMU), Dhaka, Bangladesh
Mahbuba Shirin Department of Radiology and Imaging, Bangladesh Medical University (BMU), Dhaka, Bangladesh
Mahmuda Monowara Department of Radiology and Imaging, Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh
Tania Sultana Department of Radiology and Imaging, Dhaka Medical College and Hospital, Dhaka, Bangladesh
Bipasha Mosharof Department of Radiology and Imaging, Dhaka Medical College and Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20260398

Keywords:

Liver cirrhosis, Portal hypertension, Pulsatility index, Complete spectral widening

Abstract

Background: Liver cirrhosis causes progressive hepatic fibrosis leading to increased intrahepatic vascular resistance and portal hypertension. This study aimed to assess portal vein pulsatility index and complete spectral widening on Doppler ultrasonography as non-invasive indicators of disease severity and their correlation with Child-Pugh classification.

Methods: This cross-sectional study was conducted from January 2024 to September 2025 in the Department of Radiology and Imaging at Bangladesh Medical University (BMU), Dhaka. Portal vein Doppler studies were performed on 30 patients with liver cirrhosis and portal hypertension and 30 healthy adults. The parameters evaluated were portal vein pulsatility index (PI) and complete spectral widening (CSW). Data were analyzed using SPSS version 27.0, with a p value <0.05 considered statistically significant.

Results: Among 60 participants (30 cirrhotic, 30 healthy), cirrhotics had mean age 48.2±12.9 years, 66.7% male. Ascites occurred in 76.7%, hematemesis in 30.0%, jaundice in 23.3%; mean albumin 3.04±0.65 g/dl, bilirubin 2.01±0.48 mg/dl, PT 6.56±2.54 s. Child-Pugh classes: A 30.0%, B 36.7%, C 33.3%. PI was lower in cirrhotics (0.15±0.037 vs 0.41±0.044, p<0.001) and decreased with severity (0.19→0.15→0.12, p<0.001). ROC (cut-off 0.35) showed 96.7% sensitivity, 86.7% specificity, 91.7% accuracy (AUC 0.968); CSW present in 80.0%.

Conclusion: Portal vein pulsatility index and complete spectral widening provide a simple, non-invasive, and highly accurate method for diagnosing and grading liver cirrhosis.

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