Value of Color Doppler Ultrasonography in Quantitative Evaluation of Splenic Vein Diameter and Portal Vein Diameter in Patients with Hepatitis B Hepatic Fibrosis

doi:10.7517/issn.1674-0475.230602

Abstract

Abstract: To investigate the relationship between splenic vein diameter (SVD), portal vein diameter (PVD), and semi-quantitative scoring and liver fibrosis in patients with hepatitis B. A total of 202 patients with hepatitis B who underwent ultrasound-guided liver biops. Based on the results of liver biopsy, the patients were divided into the liver fibrosis group (n=112) and the non-fibrosis group (n=90). Logistic regression analysis was used to explore the relationship between various indicators and liver fibrosis in patients with hepatitis B. A predictive model for liver fibrosis and a risk scoring system were constructed, and risk levels were 238 determined. The results showed that Elevated SVD, elevated PVD, increased splenic thickness, increased spleen area, increased gallbladder wall thickness, increased liver surface membrane height, increased peak blood flow velocity of the hepatic artery (HAV_max), increased liver stiffness measurement (LSM), and elevated alanine aminotransferase (ALT) were independent risk factors for liver fibrosis in patients with hepatitis B. Decreased spleen length, decreased liver parenchymal echo, decreased clarity of liver veins, increased peak blood flow velocity of the portal vein (PVV_max), and increased peak blood flow velocity of the splenic vein (SVV_max) were protective factors (P<0.05). SVD and PVD had a significant nonlinear relationship with liver fibrosis in hepatitis B patients (P<0.05). Risk scoring was performed for each influencing factor, with a total score ranging from 0.5 to 24. Based on the percentiles, the scores were classified into low-risk group (n=84) with a score <9, moderate-risk group (n=67) with a score of 9~17, and high-risk group (n=51) with a score >17. The incidence of liver fibrosis in the high-risk group was significantly higher than that in the low-risk and moderate-risk groups (P<0.05). SVD and PVD are significantly higher in patients with hepatitis B-related fibrosis compared to those without fibrosis and are closely related to the degree of liver fibrosis.

Key words: hepatitis B, staging of hepatic fibrosis, internal diameter of portal vein, internal diameter of splenic vein, Doppler ultrasound

ZENG Xiaorong, LI Dan, MOU Ying, YU Ying. Value of Color Doppler Ultrasonography in Quantitative Evaluation of Splenic Vein Diameter and Portal Vein Diameter in Patients with Hepatitis B Hepatic Fibrosis[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(5): 238-246.

References

[1] Ayares G, Idalsoaga F, Díaz LA, et al. Current medical treatment for alcohol-associated liver disease[J]. Journal of Clinical and Experimental Hepatology, 2022, 12(5): 1333-1348.
[2] Veronese P, Dodi I, Esposito S, et al. Prevention of vertical transmission of hepatitis B virus infection[J]. World Journal of Gastroenterology, 2021, 27(26): 4182-4193.
[3] Nguyen M H, Wong G, Gane E, et al. Hepatitis B virus: Advances in prevention, diagnosis, and therapy[J]. Clinical Microbiology Reviews, 2020, 33(2): e00046- e00019.
[4] Anteby R, Klang E, Horesh N, et al. Deep learning for noninvasive liver fibrosis classification: A systematic review[J]. Liver International, 2021, 41(10): 2269-2278.
[5] Zhao D, Jing Y, Lin X, et al. The value of color Doppler ultrasound in the diagnosis of thyroid nodules: A systematic review and meta-analysis[J]. Gland Surgery, 2021, 10(12): 3369-3377.
[6] Wang L, Li J, Yang K, et al. Comparison and evaluation of non-invasive models in predicting liver inflammation and fibrosis of chronic hepatitis B virus-infected patients with high hepatitis B virus DNA and normal or mildly elevated alanine transaminase levels[J]. Medicine, 2020, 99(23): e20548.
[7] 周群, 左文革, 陈仕吉. 基于百分位数的文献计量指标研究综述[J]. 现代图书情报技术, 2013, 7: 82-88.
[8] Ginès P, Castera L, Lammert F, et al. Population screening for liver fibrosis: Toward early diagnosis and intervention for chronic liver diseases[J]. Hepatology, 2022, 75(1): 219-228.
[9] Taylor R S, Taylor R J, Bayliss S, et al. Association between fibrosis stage and outcomes of patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis[J]. Gastroenterology, 2020, 158(6): 1611-1625.
[10] Belopolskaya M, Avrutin V, Kalinina O, et al. Chronic hepatitis B in pregnant women: Current trends and approaches[J].World Journal of Gastroenterology, 2021, 27(23): 3279-3289.
[11] Mak L Y, Wong D K, Pollicino T, et al. Occult hepatitis B infection and hepatocellular carcinoma: Epidemiology, virology, hepatocarcinogenesis and clinical significance[J]. Journal of Hepatology, 2020, 73(4): 952-964.
[12] Wu L F, Bai D S, Shi L, et al. Predictors of portal vein thrombosis after laparoscopic splenectomy and azygoportal disconnection in hepatitis B cirrhosis: A prospective study[J].Surgical Endoscopy, 2022, 36(6): 4090-4098.
[13] Xu W X, Li Y M, Li J G, et al. The 96-week clinical outcomes after cessation of nucleos(t)ide analog treatment in chronic hepatitis B patients[J]. Gastroenterol Report (Oxf), 2021, 9(4): 313-322.
[14] 南东, 洪金玲, 姜海宇. 应用DCE-MRI技术评估乙型肝炎肝硬化患者食管胃底静脉曲张严重程度的效能分析[J]. 实用肝脏病杂志, 2021, 24(3): 407-410.
[15] 韩秀红. 彩色多普勒超声在慢性乙型肝炎患者中的辅助诊断价值研究[J]. 中文科技期刊数据库(全文版)医药卫生, 2022(11): 21-23.
[16] Liu C, Chen S, Yan X, et al. Diagnostic value of portal vein velocity for portal hypertension in patients with hepatitis B virus-related cirrhosis[J]. Current Medical Imaging, 2021, 17(11): 1363-1368.
[17] 赵旦波, 林义, 张敏青. 彩色多普勒超声半定量评分在乙肝肝纤维化诊断的应用价值[J].江苏医药, 2023, 49(1): 26-30.
[18] 耿芳径, 王婷. 腹部超声弹性成像对慢性乙型肝炎合并肝纤维化的临床诊断价值分析[J]. 影像研究与医学应用, 2023, 7(2): 152-154.
[19] Zhang T, Zhang G L, Deng X L, et al. APS (age, platelets, 2D shear-wave elastography) score predicts hepatocellular carcinoma in chronic hepatitis B[J]. Radiology, 2021, 301(2): 350-359.
[20] 王蓓, 周娜, 牟洋, 等. 腹部超声联合血清甲胎蛋白、高尔基体蛋白73、γ-谷氨酰转肽酶/血小板比值对慢性乙型肝炎患者肝纤维化的诊断价值研究[J]. 现代生物医学进展, 2023, 23(5): 892-897.