Frequency of Hemodynamic Variations in Hepatic Artery according to Grades of Non-Alcoholic Fatty Liver Disease on Doppler Ultrasound
DOI:
https://doi.org/10.21649/akemu.v31i4.5916Keywords:
Doppler ultrasound, Grades of fatty liver, Hepatic artery resistive index, liver span, Non-alcoholic fatty liver diseaseAbstract
Background: Non-alcoholic fatty liver disease is an important cause of hepatic related morbidity and mortality due to its spectrum from simple hepatic steatosis to fibrosis/cirrhosis; latter alter the hepatic vascular hemodynamics particularly of hepatic artery.
Objective: To evaluate the hemodynamic variations in Hepatic artery in subjects with non-alcoholic fatty liver disease (NAFLD) on Doppler Ultrasound and correlate it with different grades of NAFLD.
Methods: This hospital based observational study was done in the Department of Radiology, Dr Ruth K.M. Pfau Civil Hospital Karachi from September 2023 to August 2024. This study enrolled 139 subjects of either gender between 18-55 years of age with NAFLD according to study criteria. Then ultrasound was performed to grade the NAFLD and measure the liver span followed by Doppler ultrasound of hepatic artery to calculate resistive index (HARI).
Results: There were 90 (64.7%) males and 49 (35.3%) females with mean age of 43.7 ± 9.9 years. Grade I fatty liver was more common seen in 70 (50.4%) subjects followed by grade II in 53 (38.1%) and grade III in 16 (11.5%) subjects. Liver span was increased with raising severity of fatty liver seen in 32 (23%) subjects. Hepatic artery Resistive Index decreased as the grades of fatty liver increased; HARI was 0.77 ± 0.05 in grade I, 0.72 ± 0.05 in grade II and 0.68 ± 0.03 in grade III.
Conclusion: Hepatic artery RI decreases with the severity of fatty liver so Doppler ultrasound is reliable and cost effective imaging modality to assess the hemodynamic changes in hepatic artery in NAFLD patients.
References
1. Lin S, Huang J, Wang M, Kumar R, Liu Y, Liu S, et al. Comparison of MAFLD and NAFLD diagnostic criteria in real world. Liver Int Off J Int Assoc Study Liver. 2020; 40(9):2082–9. doi: 10.1111/liv.14548.
2. Umar LB, Sohail S, Shaikh R. Frequency and Local Hemodynamic Effects of Carotid Lesions Among Patients with Different Grades of Uncomplicated Metabolic Associated Fatty Liver Disease. Pak J Radio. 2024; 34 (2): 73-8.
3. Soresi M, Giannitrapani L, Noto D, Terranova A, Campagna ME, Cefalù AB, et al. Effects of Steatosis on Hepatic Hemodynamics in Patients with Metabolic Syndrome. Ultrasound Med Biol. 2015; 41(6): 1545-52. doi: 10.1016/j.ultrasmedbio.2015.01.020.
4. Mohammadi A, Ghasemi-rad M, Zahedi H, Toldi G, Alinia T. Effect of severity of steatosis as assessed ultrasonographically on hepatic vascular indices in non-alcoholic fatty liver disease. Med Ultrason. 2011;13(3):200-6.
5. Aslan A, Tureli D, Aslan M, Tuney D. Effects of Nonalcoholic Fatty Liver Disease on the Hepatic Vein and Artery. J Med Diagn Meth. 2014; 3(1):161. doi: doi.org/10.4172/2168-9784.1000161
6. Iqbal S, Khan S, Iqbal M, Iman N. Frequency of nonalcoholic fatty liver disease in general medical out patients. J Med Sci. 2018; 26(3): 202-6.
7. Dilek O, Kaya O. Can portal vein pulsatility index be used as predictive parameter with hepatic artery resistive index for liver fibrosis in nonalcoholic hepatosteatosis? Acta Med Alanya. 2020;4(2):156-60. doi: doi.org/10.30565/medalanya.689601
8. Bony MNRI, Islam MU, Devnath P, Safrin N, Moonmoon MA. Duplex Color Doppler Measurement of Hepatic Artery Resistance Index in Evaluation of Severity of Hepatic Steatosis. Int Res J Gastroenterol Hepatol. 2020;3(1): 19-26.
9. Balasubramanian P, Boopathy V, Govindasamy E, Venkatesh BP. Assessment of Portal Venous and Hepatic Artery Haemodynamic Variation in Non-Alcoholic Fatty Liver Disease (NAFLD) Patients. J Clin Diagn Res. 2016; 10(8):7-10. doi.org/10.7860/JCDR/2016/20697/8267
10. Soleimantabar H, Nasiri S, Gharebakhshi F, Ahmadi S. Comparison of Resistive Index, Pulsatility Index, and Arterial Waveform at the Site of Hepatic Artery Bifurcation in Patients with and without Nonalcoholic, Non-Diabetic Fatty Liver. Nov Biomed. 2025; 1 (1):34-8.
11. Alkabeer A, Mansour T, Abd El Kader M, Abd El Naser M. Relationship between Hepatic Artery Resistive Index and Liver Fibrosis Score in Non-Alcoholic Fatty Liver Disease Patient. Egypt J Hosp Med. 2020; 81 (5): 2093-8.
12. Sabry M, Youssef T, Shaker M, Salama MM, Assem N, Anwar CA. Portal venous and hepatic artery hemodynamic variation in non-alcoholic fatty liver disease. Egypt Liver J. 2021; 11 (1): 58. DOI: https://doi.org/10.1186/s43066-021-00130-7
13. Tana C, Tana M, Rossi S, Silingardi M, Schiavone C. Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution. J Ultrasound. 2016; 19(3):183-9. doi: doi/org/10.1007/s40477-016-0203-8
14. Mahaling DU, Basavaraj MM, Bika AJ. Comparison of lipid profile in different grades of non-alcoholic fatty liver disease diagnosed on ultrasound. Asian Pac J Trop Biomed. 2013; 3 (11): 907-12.
15. Alshehri AS, Gameraddin M, Saeedullah Y, Alaeinbawi MH, Altamimi BR, Gareeballah A, et al. Hepatic Artery and Portal Vein Hemodynamics in Nonalcoholic Fatty Liver Disease in Adult Saudi Patients: A Doppler Ultrasound Study. Int J Biomed. 2023;13(2):259-64. doi: doi.org/10.21103/Article13(2)_OA10
16. Preciado-Puga MC, Ruiz-Noa Y, Garcia-Ramirez JR, Jordan-Perez B, Garnelo-Cabañas S, Lazo de la Vega-Monroy ML, et al. Non-invasive diagnosis of non-alcoholic fatty liver disease using an algorithm combining clinical indexes and ultrasonographic measures. Ann Hepatol. 2021; 21 (1): 100264. Doi: doi.org/10.1016/j.aohep.2020.09.008
17. Karasin M, Tokgoz O, Serifoglu I, Oz I, Erdem O. The Doppler ultrasonographic evaluation of hemodynamic changes in hepatic vascular structures in patients with hepatosteatosis. Pol J Radiol. 2014;79 (1):299-304. doi: doi.org/10.12659/PJR.890608
18. Rui F, Jufang W, Jinman D. Association between body mass index and fatty liver risk: A dose-response analysis. Sci Rep. 2018; 8 (1):15273
19. Tarzamni MK, Khoshbaten M, Sadrarhami S, Daneshpajouhnejad P, Jalili J, Gholamian M, et al. Hepatic Artery and Portal Vein Doppler Indexes in Non-alcoholic Fatty Liver Disease Before and After Treatment to Prevent Unnecessary Health Care Costs. Int J Prev Med. 2014;5(4):472-7.
20. Mohammadinia AR, Bakhtavar K, Ebrahimi-Daryani N, Habibollahi P, Keramati MR, Fereshtehnejad SM, et al. Correlation of hepatic vein Doppler waveform and hepatic artery resistance index with the severity of nonalcoholic fatty liver disease. J Clin Ultrasound. 2010;38 (1): 346 - 52. DOI: 10.1002/jcu.20696.
21. Bedewi MA, Kamal S. Doppler sonographic hemodynamics in non-alcoholic fatty liver disease. Int J Pharm Res. 2019; 46(1): 283-6.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Annals of King Edward Medical University
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk