Duplex doppler ultrasound examination of the portal venous system

An emerging novel technique for the estimation of portal vein pressure

Ashwani K. Singal, Masood Ahmad, Roger D. Soloway

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose Measurement of portal venous pressure in patients with portal hypertension is important to assess efficacy of beta blockers in patients with esophageal varices. Currently, the gold standard for measurement of portal venous pressure is the estimation of hepatic venous pressure gradient (HVPG). Being an invasive technique, serial measurements of HVPG are not feasible in clinical practice. In this respect, duplex Doppler ultrasound (DDUS) examination is an upcoming non-invasive technique for the estimation of portal venous and splanchnic hemodynamics. The aim of the present review is to analyze the current literature focusing on how the two techniques compare to each other in terms of assessing the portal pressure and assessing pitfalls in the current technique. Results Duplex Doppler ultrasound (DDUS) currently has limitations in measuring the portal pressure in a non-invasive way. Hemodynamic venous and arterial indices measured on DDUS correlate with the HVPG. The technique has been refined, however, there is no uniform surrogate marker that can be used in clinical practice. Conclusions More studies are needed in order to remove the shortcomings in the current technique. The target is to be able to measure the actual portal pressure or at least derive an ideal venous or arterial hemodynamic surrogate marker having close correlation with the HVPG.

Original languageEnglish (US)
Pages (from-to)1230-1240
Number of pages11
JournalDigestive Diseases and Sciences
Volume55
Issue number5
DOIs
StatePublished - May 2010

Fingerprint

Portal System
Portal Pressure
Doppler Ultrasonography
Portal Vein
Venous Pressure
Hemodynamics
Liver
Biomarkers
Viscera
Esophageal and Gastric Varices
Portal Hypertension

Keywords

  • Beta blockers
  • Doppler ultrasound
  • Duplex ultrasound
  • Portal hypertension
  • Portal pressure
  • Variceal hemorrhage

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Duplex doppler ultrasound examination of the portal venous system : An emerging novel technique for the estimation of portal vein pressure. / Singal, Ashwani K.; Ahmad, Masood; Soloway, Roger D.

In: Digestive Diseases and Sciences, Vol. 55, No. 5, 05.2010, p. 1230-1240.

Research output: Contribution to journalArticle

@article{b0ed9e3f6ffa450199e298ff7b189dc1,
title = "Duplex doppler ultrasound examination of the portal venous system: An emerging novel technique for the estimation of portal vein pressure",
abstract = "Purpose Measurement of portal venous pressure in patients with portal hypertension is important to assess efficacy of beta blockers in patients with esophageal varices. Currently, the gold standard for measurement of portal venous pressure is the estimation of hepatic venous pressure gradient (HVPG). Being an invasive technique, serial measurements of HVPG are not feasible in clinical practice. In this respect, duplex Doppler ultrasound (DDUS) examination is an upcoming non-invasive technique for the estimation of portal venous and splanchnic hemodynamics. The aim of the present review is to analyze the current literature focusing on how the two techniques compare to each other in terms of assessing the portal pressure and assessing pitfalls in the current technique. Results Duplex Doppler ultrasound (DDUS) currently has limitations in measuring the portal pressure in a non-invasive way. Hemodynamic venous and arterial indices measured on DDUS correlate with the HVPG. The technique has been refined, however, there is no uniform surrogate marker that can be used in clinical practice. Conclusions More studies are needed in order to remove the shortcomings in the current technique. The target is to be able to measure the actual portal pressure or at least derive an ideal venous or arterial hemodynamic surrogate marker having close correlation with the HVPG.",
keywords = "Beta blockers, Doppler ultrasound, Duplex ultrasound, Portal hypertension, Portal pressure, Variceal hemorrhage",
author = "Singal, {Ashwani K.} and Masood Ahmad and Soloway, {Roger D.}",
year = "2010",
month = "5",
doi = "10.1007/s10620-009-0887-0",
language = "English (US)",
volume = "55",
pages = "1230--1240",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - Duplex doppler ultrasound examination of the portal venous system

T2 - An emerging novel technique for the estimation of portal vein pressure

AU - Singal, Ashwani K.

AU - Ahmad, Masood

AU - Soloway, Roger D.

PY - 2010/5

Y1 - 2010/5

N2 - Purpose Measurement of portal venous pressure in patients with portal hypertension is important to assess efficacy of beta blockers in patients with esophageal varices. Currently, the gold standard for measurement of portal venous pressure is the estimation of hepatic venous pressure gradient (HVPG). Being an invasive technique, serial measurements of HVPG are not feasible in clinical practice. In this respect, duplex Doppler ultrasound (DDUS) examination is an upcoming non-invasive technique for the estimation of portal venous and splanchnic hemodynamics. The aim of the present review is to analyze the current literature focusing on how the two techniques compare to each other in terms of assessing the portal pressure and assessing pitfalls in the current technique. Results Duplex Doppler ultrasound (DDUS) currently has limitations in measuring the portal pressure in a non-invasive way. Hemodynamic venous and arterial indices measured on DDUS correlate with the HVPG. The technique has been refined, however, there is no uniform surrogate marker that can be used in clinical practice. Conclusions More studies are needed in order to remove the shortcomings in the current technique. The target is to be able to measure the actual portal pressure or at least derive an ideal venous or arterial hemodynamic surrogate marker having close correlation with the HVPG.

AB - Purpose Measurement of portal venous pressure in patients with portal hypertension is important to assess efficacy of beta blockers in patients with esophageal varices. Currently, the gold standard for measurement of portal venous pressure is the estimation of hepatic venous pressure gradient (HVPG). Being an invasive technique, serial measurements of HVPG are not feasible in clinical practice. In this respect, duplex Doppler ultrasound (DDUS) examination is an upcoming non-invasive technique for the estimation of portal venous and splanchnic hemodynamics. The aim of the present review is to analyze the current literature focusing on how the two techniques compare to each other in terms of assessing the portal pressure and assessing pitfalls in the current technique. Results Duplex Doppler ultrasound (DDUS) currently has limitations in measuring the portal pressure in a non-invasive way. Hemodynamic venous and arterial indices measured on DDUS correlate with the HVPG. The technique has been refined, however, there is no uniform surrogate marker that can be used in clinical practice. Conclusions More studies are needed in order to remove the shortcomings in the current technique. The target is to be able to measure the actual portal pressure or at least derive an ideal venous or arterial hemodynamic surrogate marker having close correlation with the HVPG.

KW - Beta blockers

KW - Doppler ultrasound

KW - Duplex ultrasound

KW - Portal hypertension

KW - Portal pressure

KW - Variceal hemorrhage

UR - http://www.scopus.com/inward/record.url?scp=77953640133&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953640133&partnerID=8YFLogxK

U2 - 10.1007/s10620-009-0887-0

DO - 10.1007/s10620-009-0887-0

M3 - Article

VL - 55

SP - 1230

EP - 1240

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

IS - 5

ER -