Evaluation of hepatic blood flow ultrasound parameters in assessing esophageal varices in patients with hepatitis B cirrhosis

Abstract

Abstract: Objective To explore the evaluation value of hepatic blood flow ultrasound parameters in assessing esophageal varices (EV) in patients with hepatitis B cirrhosis and to assess their potential role in predicting the occurrence and severity of EV. Methods A total of 118 patients with hepatitis B-related cirrhosis who underwent Doppler ultrasound and contrast-enhanced ultrasound from October 2022 to November 2023 at our hospital were selected. Liver blood flow ultrasound parameters and the Fibrosis-4 (FIB-4) index were measured, and all patients underwent gastroscopy to assess the occurrence and severity of EV. Results Gastroscopy revealed that 80 patients had esophageal varices (EV), with 21 severe EVs, 30 moderate EVs, and 29 mild EVs. In the cirrhosis with EV group, the portal vein velocity (PVV) and hepatic vein arrival time (HVAT) were (15.42 ± 2.63) cm/s and (15.55 ± 2.74) s, respectively, lower than those in the cirrhosis-only group, which were (18.71 ± 2.43) cm/s and (21.82 ± 3.84) s (P<0.001). The portal vein diameter (PVD), portal vein pressure index (PV-CI), hepatic vein diameter index (HV-DI), and FIB-4 index were (1.71 ± 0.34) cm, (0.41 ± 0.13) cm/s, (0.82 ± 0.21), and (4.81 ± 1.70), respectively, higher than those in the cirrhosis-only group, which were (1.32 ± 0.31) cm, (0.22 ± 0.11) cm/s, (0.61 ± 0.13), and (2.82 ± 1.02) (P<0.001).In the different severity groups of EV, patients with severe EV had a PVV of (12.42 ± 2.92) cm/s and HVAT of (9.26 ± 2.94) s, lower than the PVV of (14.92 ± 2.20) cm/s and HVAT of (13.03 ± 2.46) s in the moderate EV group, or the PVV of (18.11 ± 2.24) cm/s and HVAT of (22.71 ± 2.52) s in the mild EV group (P<0.001), the PVD, PV-CI, HV-DI, and FIB-4 index in the severe EV group were (2.39 ± 0.52) cm, (0.81 ± 0.24) cm/s, (1.22 ± 0.23), and (6.71 ± 1.91), higher than those in the moderate EV group, which were (1.62 ± 0.20) cm, (0.32 ± 0.10) cm/s, (0.83 ± 0.21), and (4.93 ± 1.74), and the mild EV group, which were (1.31 ± 0.21) cm, (0.21 ± 0.10) cm/s, (0.52 ± 0.10), and (3.31 ± 1.16) (P<0.001).In a 12-month follow-up, 54 patients had bleeding from esophageal varices (EVB). The PVV and HVAT in the bleeding group were (14.72 ± 2.51) cm/s and (12.91 ± 2.13) s, lower than those in the non-bleeding group, which were (16.87 ± 2.77) cm/s and (21.03 ± 3.24) s (P<0.001). The PVD, PV-CI, HV-DI, and FIB-4 index in the bleeding group were (1.85 ± 0.42) cm, (0.49 ± 0.23) cm/s, (0.90 ± 0.22), and (5.40 ± 1.93), higher than those in the non-bleeding group, which were (1.42 ± 0.32) cm, (0.24 ± 0.11) cm/s, (0.65 ± 0.11), and (3.58 ± 1.40) (P<0.001). Conclusion Hepatic blood flow ultrasound parameters, such as PVV, HVAT, PVD, PV-CI, and FIB-4, are of significant clinical value in evaluating the severity of esophageal varices and the risk of bleeding in patients with hepatitis B cirrhosis, providing an effective tool for clinical assessment.

Key words: Hepatitis B, Cirrhosis, Esophageal varices, Ultrasound parameters, Portal vein velocity, FIB-4 index

NUlimangu·Maimaiti, BUajiguli·Yasenjiang, SONG Tao, LIU Huan, WU Shi-ji, DIlinuer·Yuetikuer. Evaluation of hepatic blood flow ultrasound parameters in assessing esophageal varices in patients with hepatitis B cirrhosis[J]. Chinese Hepatolgy, 2025, 30(12): 1678-1681.

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