Sonographic Assessment of Respiratory Variations in Diameter of Portal and Splenic Veins in Cirrhotic Patients and Healthy Controls

Background/Objectives: This study was designed to assess the sensitivity and specificity of respiratory changes in the diameter of splanchnic veins in non invasive diagnosis of cirrhosis regardless of the portal pressure (about 60% of cirrhotic patients have signs of portal hypertension). Patients and Methods: In this study, 36 biopsy-proven cirrhotic patients were selected as the case group and 36 healthy people as the controls. All patients had overnight fasting, and ultrasonography was performed both in normal and deep inspiration. The portal vein diameter was measured where it crosses the IVC; and the splenic vein at the splenic hilum. Results: An increased diameter of the portal (>13 mm) and splenic veins (>10mm) had a high specificity (94% and 97%, respectively) but a low sensitivity (31% and 42%) in the diagnosis of cirrhosis. Reduced respiratory changes of diameter (equal or less than 20% for the portal vein and 50% for the splenic vein ) had higher sensitivity and specificity (89% and 89% for the portal vein; and 100% and 83% for the splenic vein). Portal vein thrombosis was noted in 17.3%. Conclusion: Reduced respiratory changes in diameters of the portal and splenic veins not only has high sensitivity and specificity for diagnosing portal hypertension (as previous studies proved it) but also has similar high sensitivity and specificity for diagnosing cirrhosis regardless of portal pressure