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Functional hepatic flow and Doppler-assessed total hepatic flow in control subjects and in patients with cirrhosis

1995; Elsevier BV; Volume: 23; Issue: 2 Linguagem: Inglês

10.1016/0168-8278(95)80326-2

1600-0641

Marco Zoli, Donatella Magalotti, Giampaolo Bianchi, G Gino, Cristina Orlandini, Michele Grimaldi, Giulio Marchesini, E Pisi,

Hepatocellular Carcinoma Treatment and Prognosis

Abstract Functional hepatic flow and total hepatic flow were determined by non-invasive techniques in 32 patients with cirrhosis and in 32 paired control subjects. Functional hepatic flow was measured by the hepatic clearance of D-sorbitol, while total hepatic flow was determined by pulsed echo-Doppler, as the sum of portal and hepatic arterial blood flow. Functional hepatic flow was significantly reduced in patients with cirrhosis (927±314 vs. 1287±315; p <0.0001), while total hepatic flow was slightly increased (1511±540 vs. 1261±321 in controls; p = 0.028). In control subjects functional hepatic flow significantly correlated with total hepatic flow ( r =0.823; p <0.001), while no correlation was observed in cirrhosis. Functional hepatic flow and the difference between total hepatic flow and functional hepatic flow significantly correlated with the Child-Pugh score in patients with cirrhosis. The data obtained in control subjects support the measurement of functional hepatic flow and total hepatic flow by non-invasive techniques. The finding that in cirrhosis functional hepatic flow is significantly decreased, while Doppler-assessed total hepatic flow is preserved or even increased, confirms that a relevant part of blood flowing through the liver is diverted by intrahepatic shunts. The simultaneous assessment of these two parameters by non-invasive techniques may be proposed as a reliable tool for the study of functional shunting of cirrhosis.