Objective: To estimate prognostic value of Doppler ultrasonography in diagnostics of severe liver fibrosis (F2-F4).
Methods: One hundred patients with chronic hepatitis diagnosis: 62 % (HCVRNA +) and 38 % (HBVDNA +), mean age 44.9±14.0 years, M 55, F 45, were investigated at Vasilenko clinic of MMA. Liver fibrosis stage was assessed by METAVIR. The Doppler mode was used to measure diameter and velocity scores of portal (PV) and splenic veins (SV), common hepatic artery (CHA), splenic artery (SA) in celiac trunk area. Multifactor regression analysis of the most significant scores for revealing severe liver fibrosis was carried out. The selected parameters were studied by ROC-curves plotting. Patients were grouped according to the liver fibrosis stage (F0-F1) and (F2-F4). Statistical analysis was done at SPSS 16.0.
Results: Multifactor regression analysis has revealed, that changes of mean velocity of PV blood flow (MVPV) and SA pulsatility index (SAPI) indicate the presence of severe liver fibrosis. ROC-curves analysis has revealed, that prognostic value of the area under the curve for SAPI at severe fibrosis is 84.3 % (AUROC 0.843; 95%-CI 0.755-0.930; p <0.001). Prognostic value of area under the curve for MVPV at severe fibrosis was 69.5 % (AUROC 0.695; 95%-CI 0.591-0.820; p=0.001)
Conclusions: Evaluation of MVPV and SAPI scores brings a convincing input in non-invasive diagnostics of severe liver fibrosis (F2-F4). Progression of fibrosis is accompanied by decrease of linear blood flow velocity in PV and increase of SV, CHA and SA diameters.