Grading portal vein stenosis following partial hepatectomy by high-frequency ultrasonography: an in vivo study of rats.

Abstract

Purpose: To evaluate the diagnostic value of ultrasound in grading portal vein stenosis (PVS) in a rat model of 70% partial hepatectomy (PH).

Methods: A total of 96 Sprague-Dawley rats were randomly divided into a PH group and PVS groups with mild, moderate, and severe PVS following PH. Hemodynamic parameters were measured using high-frequency ultrasound (5-12 MHz high-frequency linear transducer), including pre-stenotic, stenotic, and post-stenotic portal vein diameters (PVD_pre, PVD_s, PVDpost); pre-stenotic and stenotic portal vein velocity (PVVpre, PVVs); hepatic artery peak systolic velocity (PSV); end-diastolic velocity; and resistive index. The portal vein diameter ratio (PVDR) and portal vein velocity ratio (PVVR) were calculated using the following formulas: PVDR=PVD_pre/PVD_s and PVVR=PVVs/PVVpre. The value of these parameters in grading PVS was assessed.

Results: Portal vein hemodynamics showed gradient changes as PVS aggravated. For identifying >50% PVS, PVD_s and PVDR were the best parameters, with areas under the curve (AUC) of 0.85 and 0.86, respectively. For identifying >65% PVS, PVD_s, PVDR, and PVVR were relatively better, with AUCs of 0.94, 0.85, and 0.88, respectively. The AUC of hepatic artery PSV for identifying >65% PVS was 0.733.

Conclusion: High-frequency ultrasonography can be used to grade PVS in rats, with PVD_s, PVDR, and PVVR being particularly useful. Hepatic artery PSV may help in predicting >65% PVS. These findings provide valuable information for PVS rat model research and offer an experimental basis for further studies on PVS evaluation in living-donor liver transplantation (LDLT).

Clinical significance: Ultrasonography serves as a first-line technology for diagnosing PVS following LDLT. However, the grading criteria for PVS severity remain unclear. Investigating the use of ultrasonic hemodynamics in the early diagnosis of PVS and grading stenosis severity is important for early postoperative intervention and improving recipient survival rates.