SONOGRAPHIC CORRELATION BETWEEN PORTAL VEIN DIAMETER AND SPLEEN LENGTH IN PATIENTS WITH CHRONIC LIVER DISEASE

Abstract

Background: For several decades, ultrasonography (US) and Doppler US have been widely used to diagnose splenomegaly and portal vein diameter. It has become the most common and valuable diagnostic modality for detecting not only parenchymal disease but also anomalies in liver hemodynamics via Doppler imaging due to its low cost, ease of use, and high patient compliance. As a result, previous studies have evaluated several US indices used to identify cirrhosis, such as nodular liver surface, blunted liver edge, coarse parenchymal echogenicity, atrophic change of the right lobe, splenomegaly, and enlarged splenic vein diameter (SV). Furthermore, Doppler US indices, which have been widely used to assess PH, include measurements of portal and splenic venous blood velocity.

Objective(s): To determine the correlation between portal vein diameter and spleen size (craniocaudal)

Methodology: T he study was conducted at the National hospital and medical center, Lahore Pakistan. All the individuals who referred for abdominal sonographic examination, including male, female, older and younger were conveniently included in the study, voluntarily, irrespective of the disease state. Ultrasonographic measurements of the caudocranial length of the spleen and portal vein were carried out on all of the one thousand subjects. The subject position for spleen was supine or right posterior oblique during suspended inspiration and right anterior oblique position for portal vein diameter with quiet respiration.

Results: In this study total of 65 patients were include in which 30 patient were female and 35 were male and out of 65 in46 patients, Hypertension was diagnosed in 29 males 17 female and  out 65 in 52 patient diabetes mellitus was seen  30  male and 22 female . Patient with CLD 23 male were chain smoker and 3 male were consume alcohol regularly. In this study 34 patients was obese 18 male and 16 female. Out of 65 patient chronic liver diseases 50 patient has hepatitis C and 6 presented with NAFLD other patient with CLD caused by alcoholic fatty liver and hepatitis B and frequency of alcoholic fatty liver and hepatitis B was 4. Ten patients present with the sharp edge of liver and 8 presented with blunt edge. Out of 65 patient , in 26 patients splenomegaly was scene. It was also observed that 17 patients out of 65 present with dilated portal vein diameter. When portal vein diameter was correlate with the splenomegaly it was observed that 1 patients with splenomegaly have normal portal vein diameter and 25 patients out of 26 splenomegaly patients have increased portal vein diameter. Mean portal vein size was 13.457 mm, minimum size measured was 6.5 mm and maximum 21.5 mm ,the average size of spleen measured in 65 patients was 13.458 cm and minimum size observed was 7.0 cm and maximum size of spleen observed was 21.0 cm. when the correlation of spleen size and portal vein was checked was found between the caudocranial length of the spleen and portal vein diameter with P-value (0.001), the correlation was significant at less than 0.01 level and R-value (0.997), which is near to 1, represents a strong positive relationship and he concluded  that Portal vein diameter and splenic craniocaudal length are linearly correlated.

Conclusion(s): The diameter of the portal vein and the splenic craniocaudal length are linearly related. In the case of chronic liver parenchymal disease, an increase in spleen size may predict an increase in portal vein diameter (liver congestion).