Non-invasive Predictors of Portal Hypertension in Patients with

Abstract

is study was conducted trying to achieve two main aims. Primary Aim: To find clinical, biochemical and ultrasonographic Doppler parameters with good predictive power for non-invasive assessment of portal hypertension in Child A patients with hepatocellular carcinoma on top of HCV related chronic liver disease. Secondary Aim: To be able to identify patients with portal hypertension non-invasively, so these patients can be excluded from hepatic resection list. In order to fulfil aims of this study, 112 patients with hepatocellular carcinoma on top of HCV related chronic liver disease and with compensated liver were included. Every patient was subjected to 1- Complete History taking 2- Thorough clinical examination 3- Laboratory Investigations including: Complete blood count (CBC), ALT, AST, albumin, total and direct bilirubin, prothrombin time, serum blood urea nitrogen (BUN), creatinine, sdium, potassium levels, HBs Ag, HCV Ab, HBcore IgG and Serum alpha-fetoprotein. 4- Ultrasound Doppler parameters including: A) Splenic size and presence of collaterals. B) Portal vein diameter, portal vein cross sectional area, portal vein mean flow velocity and portal vein congestion index. C) Splenic vein diameter, splenic vein cross sectional area, splenic vein mean flow velocity and splenic vein congestion index. D) Hepatic artery resistance index, splenic artery resistance index and renal artery resistance index. E) Portal hypertensive index and modified liver vascular index. F) Hepatic venous Doppler pattern. 5- Giannini index (platelet count/spleen diameter ratio) 6- Upper GIT endoscope 7- Triphasic spiral CT 8- Measurement of HVPG