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Color Doppler US Evaluatıon Of Hepatic And Renal Hemodynamıcs In The Cirrhosis

Yıl 2007, Cilt: 12 Sayı: 1, 28 - 33, 01.02.2007

Selami Serhatlıoğlu Özgür Kocaöz Adem Kırış Hadi Uysal Mehmet Yalnız A.y.erkin Oğur

Öz

Objectives: We aimed to figure out the value of colour Doppler ultrasonography (CDUS) to determine the hepatic and renal hemodynamics in cirrhotic patients. Materials and Methods: 40 cirrhotic patients (11 Child A, 17 Child B and 12 Child C) and a control group of 20 healthy individuals were examined. Renal artery resistive index, renal artery pulsatility index, hepatic artery resistive index, hepatic artery pulsatility index, portal vein velocity, portal vein diameter and hepatic vascular index were assessed in all the individuals. The cirrhotic patients were divided into subgroups according to their Child scores and presence of ascites. The statistical differences between control group, whole and subgroups of cirrhotic patients were evaluated through these parameters. Results: Statistically, there was a significant difference regarding all the parameters between cirrhotic patients and control group and between Child C group and control group (p

Anahtar Kelimeler

-

Kaynakça

  • Popper H. Pathologic aspects of cirrhosis. Am J Pathol 1977; 87: 228-264.
  • Schrier RV, Caramelo C. Hemodynamic and hormonal alterations in hepatic cirrhosis. Epstein M. The Kidney in Liver Disease, Baltimore; Williams and Wilkins, 1988; 265.
  • Groszmann RJ. Hyperdynamic circulation of liver disease 40 years later pathophysiology and clinical consequences. Hepatology 1994; 26: 1359-1363.
  • Benoit JN, Granger N. Splanchnic hemodynamics in chronic portal venous hypertension. Semin Liver Dis, 1986; 6: 287-291.
  • Kroeger RG, Groszman RJ. Increased portal venous resistance hinders portal pressure reduction during the administration of beta - adrenergic blocking agent in portal hypertensive model. Hepatology 1985; 5:97-102.
  • Benoit JN, Barrowman JA, Harper SL. Role of humoral factors in the intestinal hyperemia associated with chronic portal hypertension. Am J Physiol 1984; 247: 486-491.
  • Ebstein M, Schneider N, Befeler B. Relationship of systemic and intrarenal hemodynamics in cirrhosis. J Clin Lab Med 1977; 89: 1175-1187.
  • Fernandez-Seara J, Prieto J, Quiroga J, et al. Systemic and regional hemodynamics in patients with liver cirrhosis and ascites with and without functional renal failure. Gastroenterology 1989; 97: 1304-1312.
  • Fine LG, Sakhrani LM. Towards a physiological definition of the hepatorenal syndrome. Epstein M (editor). The kidney in liver disease. New York: Elsevier, 1983; 107-119.
  • Arroyo V, Gines P, Jimenez W, Rodes J. Ascites, renal failure and electrolyte disorders in cirrhosis: pathogenesis, diagnosis and treatment. Oxford Textbook of Clinical Hepatology. Oxford: Oxford University Press, 1991; 427- 470.
  • Epstein M, Berk DP, Hollenberg NK, et al Renal failure in patients with cirrhosis: the role of active vasoconstriction. Am J Med 1970; 49: 175-185.
  • Schrier RW, Arroyo V, Bernardi M. Peripheral arteriyel vasodilatation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis. Hepatology 1988; 8: 1151-1155.
  • Lach J, Gines P, Arroyo V. Prognostic value of arterial pressure endogenous vasoactive system and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology 1988; 94: 482-487.
  • Pinto HC, Abrantes A, Esteves AV, Almieda H, Correia PJ. Long term prognosis of patients with cirrhosis liver and upper gastrointestinal bleeding. Am J Gastroenterol 1989; 84: 1239- 1293.
  • Caeser J, Shaldon S, Chiandussi L. The use of indocyanine gren in the measurement of hepatic blood flow and as a test of hepatic function. Clin Sci 1965; 21: 43-57.
  • Huet PM, Lavoie P, Viallet A. Simultaneous estimation of hepatic and portal blood flows by an indicator dilution technique. J Lab Clin Med 1973; 83: 836-846.
  • Price JM, Voorhes AB Jr, Britton RC. Operative hemodynamic study in portal hypertension. Significance and Limitation. Arch Surg 1967; 95: 843-851.
  • Omnishi K, Saito M, Nakayama T, Jida S, Nomura F, Koen H. Portal venous hemodynamic in chronic liver disease effect of posture change and exercise. Radiology 1985; 155:757-761.
  • Moriyasu F, Ban N, Nishida O, Nakamura T, Miyake T, Uchino H. Clinical application of an ultrasonic duplex system in the quantitative measurement of portal blood flow. J Clin Ultrasound 1986; 14: 579-588.
  • Gill RW. Pulsed Doppler with B mode imaging for quantitative blood flow measurement. Ultrasound Med Biol 1979; 5: 223-225.
  • Ljubicic N, Duvnjak M, Rotkvic I, Kopjar B. İnfluence of the degree of liver failure on portal flow in patients with cirrhosis. Scand Gastroenterol 1990; 25: 395-400.
  • Chawla Y, Santa N, Dhiman K, Dilawari B. Portal hemodynamics by dupplex Doppler sonography in different grades of cirrhosis. Digestive Diseases and Sciences 1998; 43: 354-357.
  • Haag K, Rössle M, Ochs A, et al. Correlation of dupplex sonography findings and portal pressure in 375 patients with portal hypertension. AJR 1999; 172: 631-635.
  • Sabba C, Ferraioli G, Genecin P. Evaluation of postprandial hiperemia in süperior mesenteric artery and portal vein in healthy and cirhotic humans: an operator blind echo Doppler study. Hepatology 1991; 13: 714-718.
  • Omnishi K, Saito M, Nakayama T. Portal venous hemodynamic in chronic liver disease effect of posture change and exercise. Radiology 1985; 155:757-761.
  • Zironi G, Gaiani S, Fenyves D, et al. Value of measurement of mean portal flow velocity by Doppler flowmetry in the diagnosis of portal hypertension. J Hepatol 1992; 16:298-303.
  • Iwao T, Toyonaga A, Oho K, et al. Value of Doppler ultrasound parameters of portal vein and hepatic artery in the diagnosis of cirrhosis and portal hypertension. The American Journal of Gastroenterology 1997; 92: 1012-1017.
  • Schneider AW, Kalk JF, Klein CP. Hepatic arterial pulsatility index in cirrhosis: correlation with portal pressure. J Hepatology 1999; 30: 876-881.
  • Alpern MB, Rubin JM, Williams DM, Capele P. Porta hepatis duplex Doppler US with angiographic correlation. Radiology 1987; 162: 53-56.
  • Vassiliades VG, Ostrow TD, Chezmar JL, Hertzler GL, Nelson RC. Hepatic arterial resistive indices correlation with the severity of cirrhosis. Abdom Imaging 1993; 18: 61-65.
  • Piscaglia F, Gaiani S, Zironi G, et al. İntra and extrahepatic arterial resistances in chronic hepatitis and liver cirrhosis. Ultrasound in Medicine and Biology 1997; 23 : 675-682.
  • Taourel P, Blanc P, Dauzat M, et al. Doppler study of mezenteric, hepatic and portal circulation in alcoholic cirrhosis relationship between quantitative Doppler measurements and the severity of portal hypertension and hepatic failure. Hepatology 1998; 28: 932-936.
  • Maroto A, Gines A, Salo J, et al. Diagnosis of functional kidney failure in cirrhosis with Doppler sonography prognostic value of resistive index. Hepatology 1994; 20: 839-844.
  • Platt JF, Ellis JH, Rubin JM, Merion RM, Lucey MR. Renal duplex Doppler ultrasonography: a non invsive predictor of kidney dysfunction and hepatorenal failure in liver disease. Hepatology 1994; 20: 362-369.
  • Saccerdoti D, Bolognesi M, Merckel C, Angeli P, Gatta A. Renal vasoconstruction in cirrhosis evaluated by duplex Doppler ultrasonography. Hepatology 1993; 17:219-224.
  • Rivolta R, Maggi A, Cazzaniga M, et al. Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites. Hepatology 1998; 28: 1235-1240.
  • Platt JF, Marn CS, Baliga PK, et al. Renal disfunction in hepatic disease: early identification with renal duplex Doppler US in patients who undergo liver transplantation. Radiology 1992; 183: 801-806.
  • Colli A, Cocciolo M, Riva C, Martinez E. Abnormal renovascular impedance in patients with hepatic cirrhosis: detection with duplex US. Radiology 1993; 187: 561-563.
  • Abdallah AF, Bakr AM, El-Haggar M, Amer T. Renal hemodynamic changes in children with liver cirrhosis. Pediatr Nephrol 1999; 13: 854-858.
  • Kabul Tarihi: 27.12.2006

Karaciğer Sirozunda Hepatik ve Renal Hemodinamik Değişikliklerin Doppler US ile Değerlendirilmesi

Yıl 2007, Cilt: 12 Sayı: 1, 28 - 33, 01.02.2007

Selami Serhatlıoğlu Özgür Kocaöz Adem Kırış Hadi Uysal Mehmet Yalnız A.y.erkin Oğur

Öz

Amaç: Sirozlu olgularda karaciğer ve renal hemodinamilerdeki değişiklikler açısından renkli Doppler ultrasonografinin (RDUS) değerini ortaya koymayı amaçladık. Gereç ve Yöntem: Renkli Doppler ultrasonografi ile 40 sirozlu olgu (11 Child A, 17 Child B, 12 Child C) ve renal ve hepatik fonksiyonları tümüyle normal olan 20 sağlıklı kişiden oluşan kontrol grubu incelendi. Tüm olgularda renal arter rezistif indeksi (RA-RI), renal arter pulsatilite indeksi (RAPI), hepatik arter rezistif indeksi (HA-RI), hepatik arter pulsatilite indeksi (HA-PI), portal ven hızı (PV-HIZ), portal ven çapı (PV-ÇAP) ve hepatik vasküler indeksi (HVI) değerlendirildi. Sirozlu olgular Child evrelemesi ve assit varlığına göre alt gruplara ayrıldı. Bu parametreler açısından kontrol grubu, genel sirozlu grup ve alt gruplar arasındaki istatistiksel fark değerlendirildi. Bulgular: Siroz grubu ile kontrol grubu arasında ve Child C grubu ile kontrol grubu arasında tüm parametrelerde istatistiksel olarak anlamlı farklılık mevcuttu (p

Anahtar Kelimeler

Siroz hepatik arter portalven renal arter Doppler

Kaynakça

  • Popper H. Pathologic aspects of cirrhosis. Am J Pathol 1977; 87: 228-264.
  • Schrier RV, Caramelo C. Hemodynamic and hormonal alterations in hepatic cirrhosis. Epstein M. The Kidney in Liver Disease, Baltimore; Williams and Wilkins, 1988; 265.
  • Groszmann RJ. Hyperdynamic circulation of liver disease 40 years later pathophysiology and clinical consequences. Hepatology 1994; 26: 1359-1363.
  • Benoit JN, Granger N. Splanchnic hemodynamics in chronic portal venous hypertension. Semin Liver Dis, 1986; 6: 287-291.
  • Kroeger RG, Groszman RJ. Increased portal venous resistance hinders portal pressure reduction during the administration of beta - adrenergic blocking agent in portal hypertensive model. Hepatology 1985; 5:97-102.
  • Benoit JN, Barrowman JA, Harper SL. Role of humoral factors in the intestinal hyperemia associated with chronic portal hypertension. Am J Physiol 1984; 247: 486-491.
  • Ebstein M, Schneider N, Befeler B. Relationship of systemic and intrarenal hemodynamics in cirrhosis. J Clin Lab Med 1977; 89: 1175-1187.
  • Fernandez-Seara J, Prieto J, Quiroga J, et al. Systemic and regional hemodynamics in patients with liver cirrhosis and ascites with and without functional renal failure. Gastroenterology 1989; 97: 1304-1312.
  • Fine LG, Sakhrani LM. Towards a physiological definition of the hepatorenal syndrome. Epstein M (editor). The kidney in liver disease. New York: Elsevier, 1983; 107-119.
  • Arroyo V, Gines P, Jimenez W, Rodes J. Ascites, renal failure and electrolyte disorders in cirrhosis: pathogenesis, diagnosis and treatment. Oxford Textbook of Clinical Hepatology. Oxford: Oxford University Press, 1991; 427- 470.
  • Epstein M, Berk DP, Hollenberg NK, et al Renal failure in patients with cirrhosis: the role of active vasoconstriction. Am J Med 1970; 49: 175-185.
  • Schrier RW, Arroyo V, Bernardi M. Peripheral arteriyel vasodilatation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis. Hepatology 1988; 8: 1151-1155.
  • Lach J, Gines P, Arroyo V. Prognostic value of arterial pressure endogenous vasoactive system and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology 1988; 94: 482-487.
  • Pinto HC, Abrantes A, Esteves AV, Almieda H, Correia PJ. Long term prognosis of patients with cirrhosis liver and upper gastrointestinal bleeding. Am J Gastroenterol 1989; 84: 1239- 1293.
  • Caeser J, Shaldon S, Chiandussi L. The use of indocyanine gren in the measurement of hepatic blood flow and as a test of hepatic function. Clin Sci 1965; 21: 43-57.
  • Huet PM, Lavoie P, Viallet A. Simultaneous estimation of hepatic and portal blood flows by an indicator dilution technique. J Lab Clin Med 1973; 83: 836-846.
  • Price JM, Voorhes AB Jr, Britton RC. Operative hemodynamic study in portal hypertension. Significance and Limitation. Arch Surg 1967; 95: 843-851.
  • Omnishi K, Saito M, Nakayama T, Jida S, Nomura F, Koen H. Portal venous hemodynamic in chronic liver disease effect of posture change and exercise. Radiology 1985; 155:757-761.
  • Moriyasu F, Ban N, Nishida O, Nakamura T, Miyake T, Uchino H. Clinical application of an ultrasonic duplex system in the quantitative measurement of portal blood flow. J Clin Ultrasound 1986; 14: 579-588.
  • Gill RW. Pulsed Doppler with B mode imaging for quantitative blood flow measurement. Ultrasound Med Biol 1979; 5: 223-225.
  • Ljubicic N, Duvnjak M, Rotkvic I, Kopjar B. İnfluence of the degree of liver failure on portal flow in patients with cirrhosis. Scand Gastroenterol 1990; 25: 395-400.
  • Chawla Y, Santa N, Dhiman K, Dilawari B. Portal hemodynamics by dupplex Doppler sonography in different grades of cirrhosis. Digestive Diseases and Sciences 1998; 43: 354-357.
  • Haag K, Rössle M, Ochs A, et al. Correlation of dupplex sonography findings and portal pressure in 375 patients with portal hypertension. AJR 1999; 172: 631-635.
  • Sabba C, Ferraioli G, Genecin P. Evaluation of postprandial hiperemia in süperior mesenteric artery and portal vein in healthy and cirhotic humans: an operator blind echo Doppler study. Hepatology 1991; 13: 714-718.
  • Omnishi K, Saito M, Nakayama T. Portal venous hemodynamic in chronic liver disease effect of posture change and exercise. Radiology 1985; 155:757-761.
  • Zironi G, Gaiani S, Fenyves D, et al. Value of measurement of mean portal flow velocity by Doppler flowmetry in the diagnosis of portal hypertension. J Hepatol 1992; 16:298-303.
  • Iwao T, Toyonaga A, Oho K, et al. Value of Doppler ultrasound parameters of portal vein and hepatic artery in the diagnosis of cirrhosis and portal hypertension. The American Journal of Gastroenterology 1997; 92: 1012-1017.
  • Schneider AW, Kalk JF, Klein CP. Hepatic arterial pulsatility index in cirrhosis: correlation with portal pressure. J Hepatology 1999; 30: 876-881.
  • Alpern MB, Rubin JM, Williams DM, Capele P. Porta hepatis duplex Doppler US with angiographic correlation. Radiology 1987; 162: 53-56.
  • Vassiliades VG, Ostrow TD, Chezmar JL, Hertzler GL, Nelson RC. Hepatic arterial resistive indices correlation with the severity of cirrhosis. Abdom Imaging 1993; 18: 61-65.
  • Piscaglia F, Gaiani S, Zironi G, et al. İntra and extrahepatic arterial resistances in chronic hepatitis and liver cirrhosis. Ultrasound in Medicine and Biology 1997; 23 : 675-682.
  • Taourel P, Blanc P, Dauzat M, et al. Doppler study of mezenteric, hepatic and portal circulation in alcoholic cirrhosis relationship between quantitative Doppler measurements and the severity of portal hypertension and hepatic failure. Hepatology 1998; 28: 932-936.
  • Maroto A, Gines A, Salo J, et al. Diagnosis of functional kidney failure in cirrhosis with Doppler sonography prognostic value of resistive index. Hepatology 1994; 20: 839-844.
  • Platt JF, Ellis JH, Rubin JM, Merion RM, Lucey MR. Renal duplex Doppler ultrasonography: a non invsive predictor of kidney dysfunction and hepatorenal failure in liver disease. Hepatology 1994; 20: 362-369.
  • Saccerdoti D, Bolognesi M, Merckel C, Angeli P, Gatta A. Renal vasoconstruction in cirrhosis evaluated by duplex Doppler ultrasonography. Hepatology 1993; 17:219-224.
  • Rivolta R, Maggi A, Cazzaniga M, et al. Reduction of renal cortical blood flow assessed by Doppler in cirrhotic patients with refractory ascites. Hepatology 1998; 28: 1235-1240.
  • Platt JF, Marn CS, Baliga PK, et al. Renal disfunction in hepatic disease: early identification with renal duplex Doppler US in patients who undergo liver transplantation. Radiology 1992; 183: 801-806.
  • Colli A, Cocciolo M, Riva C, Martinez E. Abnormal renovascular impedance in patients with hepatic cirrhosis: detection with duplex US. Radiology 1993; 187: 561-563.
  • Abdallah AF, Bakr AM, El-Haggar M, Amer T. Renal hemodynamic changes in children with liver cirrhosis. Pediatr Nephrol 1999; 13: 854-858.
  • Kabul Tarihi: 27.12.2006
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Selami Serhatlıoğlu Bu kişi benim

Özgür Kocaöz Bu kişi benim

Adem Kırış Bu kişi benim

Hadi Uysal Bu kişi benim

Mehmet Yalnız Bu kişi benim

A.y.erkin Oğur Bu kişi benim

Yayımlanma Tarihi 1 Şubat 2007
Yayımlandığı Sayı Yıl 2007 Cilt: 12 Sayı: 1

Kaynak Göster

APA Serhatlıoğlu, S., Kocaöz, Ö., Kırış, A., Uysal, H., vd. (2007). Karaciğer Sirozunda Hepatik ve Renal Hemodinamik Değişikliklerin Doppler US ile Değerlendirilmesi. Fırat Tıp Dergisi, 12(1), 28-33.
AMA Serhatlıoğlu S, Kocaöz Ö, Kırış A, Uysal H, Yalnız M, Oğur A. Karaciğer Sirozunda Hepatik ve Renal Hemodinamik Değişikliklerin Doppler US ile Değerlendirilmesi. Fırat Tıp Dergisi. Şubat 2007;12(1):28-33.
Chicago Serhatlıoğlu, Selami, Özgür Kocaöz, Adem Kırış, Hadi Uysal, Mehmet Yalnız, ve A.y.erkin Oğur. “Karaciğer Sirozunda Hepatik Ve Renal Hemodinamik Değişikliklerin Doppler US Ile Değerlendirilmesi”. Fırat Tıp Dergisi 12, sy. 1 (Şubat 2007): 28-33.
EndNote Serhatlıoğlu S, Kocaöz Ö, Kırış A, Uysal H, Yalnız M, Oğur A (01 Şubat 2007) Karaciğer Sirozunda Hepatik ve Renal Hemodinamik Değişikliklerin Doppler US ile Değerlendirilmesi. Fırat Tıp Dergisi 12 1 28–33.
IEEE S. Serhatlıoğlu, Ö. Kocaöz, A. Kırış, H. Uysal, M. Yalnız, ve A. Oğur, “Karaciğer Sirozunda Hepatik ve Renal Hemodinamik Değişikliklerin Doppler US ile Değerlendirilmesi”, Fırat Tıp Dergisi, c. 12, sy. 1, ss. 28–33, 2007.
ISNAD Serhatlıoğlu, Selami vd. “Karaciğer Sirozunda Hepatik Ve Renal Hemodinamik Değişikliklerin Doppler US Ile Değerlendirilmesi”. Fırat Tıp Dergisi 12/1 (Şubat 2007), 28-33.
JAMA Serhatlıoğlu S, Kocaöz Ö, Kırış A, Uysal H, Yalnız M, Oğur A. Karaciğer Sirozunda Hepatik ve Renal Hemodinamik Değişikliklerin Doppler US ile Değerlendirilmesi. Fırat Tıp Dergisi. 2007;12:28–33.
MLA Serhatlıoğlu, Selami vd. “Karaciğer Sirozunda Hepatik Ve Renal Hemodinamik Değişikliklerin Doppler US Ile Değerlendirilmesi”. Fırat Tıp Dergisi, c. 12, sy. 1, 2007, ss. 28-33.
Vancouver Serhatlıoğlu S, Kocaöz Ö, Kırış A, Uysal H, Yalnız M, Oğur A. Karaciğer Sirozunda Hepatik ve Renal Hemodinamik Değişikliklerin Doppler US ile Değerlendirilmesi. Fırat Tıp Dergisi. 2007;12(1):28-33.