Correlation of Hepatic Vein Doppler Waveform and Hepatic Artery Resistance Index with the Severity of Nonalcoholic Fatty Liver Disease

Purpose. The study was conducted to evaluate the effect of various degrees of fatty infiltration in patients with nonalcoholic fatty liver disease on hepatic artery resistance index and hepatic vein waveform patterns. Methods. After identification and grading of fatty infiltration, 60 patients and 20 normal healthy subjects were examined using color and spectral Doppler sonography. The level of fatty liver infiltration was ascertained and graded by biopsy in patients and excluded by MRI in controls. The patients were allocated to four study groups consecutively, until the required number was reached, according to infiltration level as follows: normal (group A), mild (group B), moderate (group C), and severe (group D). The hepatic vein waveforms were classified into the three following groups: triphasic, biphasic, and monophasic waveform. The hepatic artery resistance index was calculated as the mean of three different measurements. Results. The incidence of monophasic and biphasic hepatic vein waveform was 2 (10%) for group B, 11 (55%) for group C, 16 (80%) for group D, and none for group A. The difference in the distribution of triphasic Doppler waveform pattern between the patients and the control group was significant (p < 0.001). Hepatic artery resistance index was 0.81 (+/- 0.02), 0.78 (+/- 0.03), 0.73 (+/- 0.03), and 0.68 (+/- 0.05), respectively, in groups A, B, C, and D and was significantly different between groups (p < 0.001). Conclusion. As the severity of nonalcoholic fatty infiltration increases, the incidence of abnormal hepatic vein waveforms increases and hepatic artery resistance index decreases. (C) 2010 Wiley Periodicals, Inc. J Clin Ultrasound 38:346-352, 2010; Published online in Wiley InterScience (www.interscience. wiley.com). DOI: 10.1002/jcu.20696