Frequency of Portal Hypertension among Patients with Liver Cirrhosis on Ultrasonography
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Background: Portal hypertension is a major consequence of cirrhosis and is associated with varices, ascites, portosystemic collateral formation, splenomegaly, and decompensation. Ultrasonography and Doppler can identify several morphological and hemodynamic features associated with portal hypertension but do not directly measure the hepatic venous pressure gradient. Objective: To determine the frequency of an ultrasound-defined portal-hypertension classification and describe associated sonographic and Doppler findings among patients with cirrhosis. Methods: An analytical cross-sectional study included 150 adults with cirrhosis examined in the Department of Diagnostic Radiology and Imaging, Sheikh Zaid Medical College and Hospital, Rahim Yar Khan. Ultrasound assessment included liver morphology, ascites, splenomegaly, portal-vein diameter and velocity, collateral pathways, portal-flow direction, cavernous transformation, and recanalized paraumbilical vein. Results: The study classified 130/150 patients (86.7%) as having portal hypertension. Splenomegaly was present in 113 (75.3%), any ascites in 107 (71.3%), portosystemic collaterals in 69 (46.0%), recanalized paraumbilical vein in 57 (38.0%), reversed portal flow in 24 (16.0%), and cavernous transformation in nine (6.0%). Mean portal-vein diameter was 13.71±1.91 mm and velocity 13.03±2.81 cm/s. Splenomegaly was strongly associated with the study-defined portal-hypertension classification, χ²(1)=70.478, p<.001, φ=0.685. Portal-vein diameter and velocity were not correlated, r=−0.007, p=.930. Conclusion: Ultrasound and Doppler identified a high burden of portal-hypertension-associated findings in this selected cirrhotic cohort. The reported 86.7% represents the study's ultrasound-based classification and should not be interpreted as independently validated hemodynamic prevalence until its operational diagnostic criteria are specified.
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