The Evaluation of Hepatic Fibrosis by the Doppler Ultra-sonography and the Tactile Sensor

Yuichi Hatakeyama, Hiroshi Sakuma, Yuji Kakinuma, Arifumi Hasegawa, Naoki Sato, Yoshihisa Koyama, Norio Inoue, Atsuo Tsuchiya, Seiichi Takenoshita and Sadao Omata^*

The Second Department of Surgery, Fukushima Medical University School of Medicine
Department of Electrical and Electronic Engineering, College of Engineering, Nihon University^*

We reported that the hepatic fibrosis index is useful to estimate hepatic regeneration activity after resection of cirrhotic liver. In this study, we examined the potential utility of Doppler ultrasonographic analysis of the hepatic vein and quantification of hardness of the liver in the evaluation of the hepatic fibrosis index. Blood examination, ICG R15 test, K ICG test and Doppler ultrasonographic analysis of the hepatic vein were performed preoperatively in fifteen patients (9 with liver cancer and 6 with other disease). The pulsatility index (PI) and the resistance index (RI) were measured by Doppler ultrasonographic analysis. In addition, we performed intraoperative quantification of the hardness of the liver using the tactile sensor and liver biopsy for measurement of the hepatic fibrosis index. A significant correlation was recognized between the hepatic fibrosis index and the PI or the tactile. A multivariate analysis also indicated that the PI and the tactile were important in the evaluation of the hepatic fibrosis index. This study showed that measurement of the PI by Doppler ultrasonographic analysis of the hepatic vein is useful before hepatectomy and intraoperative measurement of the hardness of the liver is useful during operation in order to evaluate the hepatic fibrosis index.

Key words
Doppler ultrasonography, hepatic fibrosis, liver cirrhosis, liver resection

Reprint requests
Yuichi Hatakeyama The Second Department of Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295 JAPAN

Accepted
September 22, 1999

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