# Correlation Between Hepatic Waveform Changes on Doppler Ultrasound and Disease Severity in Cirrhotic Patients

## TL;DR

This study shows that changes in liver blood flow patterns seen on Doppler ultrasound are strongly linked to the severity of cirrhosis, offering a non-invasive way to assess disease progression.

## Contribution

The study demonstrates a novel correlation between hepatic vein waveform patterns and cirrhosis severity as measured by the Child-Pugh score.

## Key findings

- Monophasic and biphasic waveforms were most common in Class C cirrhosis patients.
- Waveform patterns showed a statistically significant association with disease severity (p < 0.001).
- Waveform analysis had 100% sensitivity and negative predictive value for advanced cirrhosis.

## Abstract

Background

Liver cirrhosis is the terminal stage of chronic liver disease, marked by progressive fibrosis and vascular remodeling that alters hepatic hemodynamics. Doppler ultrasonography enables non-invasive assessment of these changes by analyzing hepatic vein waveform patterns. This study aimed to evaluate the correlation between hepatic vein waveform alterations and cirrhosis severity, as classified by the Child-Pugh score, and to assess the diagnostic performance of waveform analysis in clinical staging.

Methodology

In this prospective, observational study, 140 patients with clinically or radiologically confirmed cirrhosis underwent Doppler ultrasonography of hepatic veins. Waveform patterns were categorized as triphasic, biphasic, or monophasic and correlated with Child-Pugh classification and other demographic and laboratory parameters. Statistical analyses assessed the strength of these associations and the diagnostic accuracy of waveform classification.

Results

The cohort included 59.3% males and 40.7% females, with 45% aged 41-60 years. According to Child-Pugh classification, 22.9% of patients were Class A, 25% were Class B, and 52.1% were Class C. Hepatic vein waveforms were monophasic in 38.6%, biphasic in 36.4%, and triphasic in 25% of patients. A statistically significant association was observed between waveform patterns and disease severity (p < 0.001), with 70.4% of monophasic and 68.6% of biphasic waveforms seen in Class C patients, and 57.1% of triphasic waveforms in Class A patients. Waveform changes also correlated significantly with age (p = 0.008). Diagnostic evaluation revealed 100% sensitivity and negative predictive value, along with 52.2% specificity and 69.5% positive predictive value for predicting advanced cirrhosis.

Conclusions

Hepatic vein waveform analysis via Doppler ultrasonography is a reliable, non-invasive indicator of cirrhosis severity, demonstrating a strong correlation with the Child-Pugh classification. Its high sensitivity and negative predictive value support its utility as a screening tool for advanced disease. Integrating waveform assessment into routine ultrasound protocols offers valuable prognostic insight without additional cost or complexity.