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Portal vein Doppler study in evaluation of portal vein pulsatility pattern for assessing severity of cirrhotic patients with portal hypertension

Background Liver cirrhosis causes progressive hepatic fibrosis leading to increased intrahepatic vascular resistance and portal hypertension. This study aimed to assess portal vein pulsatility index and complete spectral widening on Doppler ultrasonography as non-invasive indicators of disease severity and their correlation with Child-Pugh classification.

Methods This cross-sectional study was conducted from January 2024 to September 2025 in the Department of Radiology and Imaging at Bangladesh Medical University (BMU), Dhaka. Portal vein Doppler studies were performed on 30 patients with liver cirrhosis and portal hypertension and 30 healthy adults. The parameters evaluated were portal vein pulsatility index (PI) and complete spectral widening (CSW). Data were analyzed using SPSS version 27.0, with a p value <0.05 considered statistically significant.

Results Among 60 participants (30 cirrhotic, 30 healthy), cirrhotics had mean age 48.2±12.9 years, 66.7% male. Ascites occurred in 76.7%, hematemesis in 30.0%, jaundice in 23.3%; mean albumin 3.04±0.65 g/dl, bilirubin 2.01±0.48 mg/dl, PT 6.56±2.54 s. Child-Pugh classes: A 30.0%, B 36.7%, C 33.3%. PI was lower in cirrhotics (0.15±0.037 vs 0.41±0.044, p<0.001) and decreased with severity (0.19→0.15→0.12, p<0.001). ROC (cut-off 0.35) showed 96.7% sensitivity, 86.7% specificity, 91.7% accuracy (AUC 0.968); CSW present in 80.0%.

Conclusion Portal vein pulsatility index and complete spectral widening provide a simple, non-invasive, and highly accurate method for diagnosing and grading liver cirrhosis.