Abstract: Objective To investigate the value of color Doppler flow spectrum of left, middle and right hepatic veins in staging liver fibrosis.Methods In this study, Color Doppler ultrasound was used to record the spectral waveforms of the left, middle, and right hepatic veins in 344 patients with chronic hepatitis. All patients were subjected to a pathological liver biopsy for diagnosis, and the spectral waveforms obtained from the hepatic veins were subsequently compared with the liver fibrosis staging.Results The 344 patients with spectral waveforms of the hepatic vein were divided into three types: bi-direction wave(type O), uni-direction wave( type I), and continuous flat wave (type II). According to the degree of liver fibrosis, patients were also grouped into mild (S0~S1), moderate (S2~S3) and severe (S4) categories. The composition ratio of the left, middle and right hepatic veins exhibiting Type O, Ⅰ and Ⅱ waves, across the mild, moderate, and severe groups, showed significant differences with χ²=30.090, 29.447, 15.572, P<0.001. The correlation between the liver fibrosis stage and type O and type Ⅱ waves of the left hepatic vein was statistical significance(r=-0.268, 0.194, P<0.001). The correlation between the liver fibrosis stage and type O, type Ⅰ and type Ⅱ waves of the middle hepatic vein was also significant(r=-0.268, 0.108, 0.154, P<0.001, <0.05, <0.05). Moreover, the correlation between the liver fibrosis stage and, type O and type Ⅱ waves of the right hepatic vein was significant(r=-0.198, 0.147, P<0.001, <0.05).Conclusion The color Doppler blood flow spectrum from three hepatic veins-left , middle and right-proved a comprehensive reflection of the liver fibrosis degree. Moreover, the spectral readings from the middle hepatic vein appears to be more reliable than those from the left and right hepatic veins when used as an evaluation index.

Key words: Hepatic hemodynamics, Portal vein, Color Doppler spectrum, Ultrasonic examination, Staging of liver fibrosis