Abstract: Objective To detect the hemodynamic changes of middle cerebral artery (MCA) in patients with different degrees of cirrhosis by transcranial Doppler ultrasound (TCD) combined with breath-holding test.Methods In the study, 20 healthy volunteers were enrolled as control group, 48 patients with cirrhosis were divided into 3 groups according to Child-Pugh grade. The mean blood flow velocity (Vm), resistance index (RI), pulsatility index (PI) and blood flow volume (BFV) of MCA were measured by TCD before and after breath-holding test, and the cerebrovascular reserve (CVR) was calculated. Results Compared with the control and group A, the PI and RI of group B and C were significantly increased (P<0.05), the Vm and BFV in group B and C were significantly decreased (P<0.05). After holding the breath, the Vm and BFV of the MCA increased, the PI and RI decreased in all groups. The CVR of group A, B and C were 39.65±12.76, 31.49±15 and 24.52±14.58, respectively, which were significantly lower than those of the control group (P<0.05), and CVR differences were significant between the 3 groups (P<0.05).Conclusion The MCA in patients with cirrhosis has different degrees of hemodynamic changes. CVR can effectively reflect the variation of MCA vascular function in patients with early cirrhosis.

Key words: Transcranial Doppler ultrasound, Middle cerebral artery, Liver cirrhosis, Breath-holding test, Cerebrovascular reserv