ABSTRACT

Background: Hepatic Doppler sonography gives vital information that helps in early and accurate detection of many hepatic disorders. The absence of local nomograms may have limited the use of these indices in early and accurate detection of the onset of hepatic diseases among Nigerians. No study has shown the relationship that exists between hepatic Doppler parameters and visceral adiposity. Aim: Our aim is to establish baseline values of the portal vein congestive index (PVCI), hepatic artery resistive index (HARI), hepatic artery pulsatility index (HAPI) and hepatic Doppler perfusion index (HDPI) in a given apparently healthy adult Nigerian population and compare these values with those of other races. We also aim at finding the relationship that may exist between these indices and visceral adipose thickness. Materials and Methods: A prospective cross-sectional study with a data capturing sheet was adopted. Diasonics spectra DCN3-2013, Mindray ultrasound machine equipped with Doppler facilities was used. The scan was carried out via two approaches: subcostal approach with the transducer pointing postero-cephalad and angled slightly to the right and right intercostal approach with transducer pointing medially and all Doppler measurements were performed under respiratory suspension in expiration state. The Doppler sample gate was adjusted to 2/3 of the vessel caliber and the transducer oriented along the longitudinal axis of the vessel of interest while the Doppler angles employed were between 30º and 60º. Visceral adipose tissue thickness was measured in the midline of the abdomen, 1 cm above the umbilical scar, during the expiratory phase, without pressure on the abdomen. Results: Normal values obtained are PVCI (0.069 ± 0.020 cmS); HARI (0.55 ± 0.16); HAPI (1.05 ± 0.11) and HDPI (0.21 ± 0.05). Independent Student’s t-test showed no statistically significant differences in the mean values of these parameters between male and female subjects. Analysis of variance revealed no statistically significant differences among the various age groups except for HDPI that showed age preponderance with age group 60-69 years showing the highest value and age group 30-39 years the lowest value. Pearson’s product moment correlation coefficient revealed that no statistical relationship exists between PVCI and VAT (r = 0.194, p = 0.211); between HARI and VAT (r = 0.036, p = 0.321); between HAPI and VAT (r = 0.027, p = 0.341) but a weak negative correlation exists between HDPI and VAT (r = -0.138, p = 0.081). Conclusion: The baseline values of four important Doppler parameters have been determined in a given apparently healthy adult Nigerian population. No significant differences exist in the values of these parameters between male and female genders and only a little variation is noted among various age groups. Any gross deviations from these values will indicate possible onset of liver pathology even when it is not yet overtly observed with routine ultrasound study. Most of these parameters are unaffected by visceral adiposity. Keywords: Doppler parameters, Portal vein congestive index, Hepatic artery resistive index, Hepatic artery pulsatility index, Hepatic Doppler perfusion index, Visceral adipose thickness

https://ijbpas.com/pdf/2019/October/MS_IJBPAS_2019_4837.pdf

Download PDF
https://doi.org/10.31032/IJBPAS/2019/8.10.4837