Hepatic Vein Doppler Waveform Changes in Nonalcoholic Fatty Liver Disease with Hepatomegaly

Aim: Doppler Ultrasonography (DUS) has become an important diagnostic technique in the hepatic vasculature evaluation. Fatty infiltration of the liver can also change the Doppler findings -like cirrhosis- of hepatic veins. Diffuse fatty liver  (DFL) is the most common finding in liver with the method of ultrasonography. Most literature reports mention the effect of chronic liver disease with a small-size liver on the waveform alterations. The objective of the study was to evaluate the hepatic vein (HV) Doppler waveforms in cases with hepatomegaly and diffuse fatty infiltration of the liver. Material and Method: Steatosis was present in all cases (Grade I: 35 (19.3%); Grade II: 129 (71.3%); and Grade III: 17 (9.4%)). Steatosis was accompanied by hepatomegaly in 107 (59.1%) cases. However, steatosis was accompanied by nonhepatomegaly in 74 (40.9%) cases. Results: Of the cases that were detected to have hepatomegaly, 35 (33%) were male and 72 (67%) were female. Their ages ranged from 27 to 83 years (mean: 53.5 ± 11.1). Hepatic vein waveforms were examined in all cases. HV waveforms were divided into 3 groups, namely regular triphasic form, biphasic form, and monophasic form. Etiologic factors were diabetes, hypertriglyceridemia, and hypercholesterolemia. An abnormal HV Doppler waveform was present in 119 (65%) of 181 cases. A correlation was detected between DFL grade and HV Doppler waveforms (p=0.03), whereas no correlation was detected between DFL grade and hepatomegaly (p=0.5). It is known that there is an association between the grade of steatosis and a change in the hepatic vein waveform. Discussion: Nevertheless, hepatomegaly that is observed with steatosis does not cause any significant change in HV flow, which can be detected with a Doppler apparatus