The Added Value of Hepatic Duplex Doppler US in the Prediction of Esophageal Varices Severity in Hepatitis C Virus‑Infected Cirrhotic Patients

Background:Esophageal varices (EV) are the most prevalent and concerning complication of portal hypertension (PH) in individuals with cirrhotic liver disease. Objective: This study aimed to determine the additional benefit of hepatic Duplex Doppler US in predicting and assessing the severity of EV in patients infected with the hepatitis C virus. Patients and methods: 200 HCV-infected patients (100 with EV and 100 without EV) were included in this cross-sectional study. We acquired clinical data and conducted grayscale and Doppler ultrasonography to investigate the determinants of EV. Our study was performed from August 2023 to April 2024 at Interventional Radiology and Medical Imaging Department, Menoufia University. Results: The mean value of age was 49.87 ± 11.26 years in non-variceal group and 56.97 ± 9.80 years in variceal group. 54 (54%) males were present in non-variceal group and 58 (58%) males in variceal group < /span>. Multivariate logistic regression analysis showed that portal vein diameter (PVD), Portal vein (PV) flow velocity, portal congestion index (PCI) and splenic index were independent predicators of severity of EVin hepatitis C virus‑infected cirrhotic patients. PCI at cut off ≥ 0.115 (P value<0.001 and Area under curve of 0.980) and 90.0% accuracy can predict the severity of EV. Conclusions: A non-invasive method for assessing PVindices (diameter and velocity), PCI, and splenic index is the ultrasound, which is also used to diagnose chronic liver disease. This study revealed lower average portal vein velocity(PVV) but higher PVD, PCI and splenic index in a patient with portal hypertension caused by liver cirrhosis. With their greater diagnostic accuracy and AUC, noninvasive indicators such as the splenic index and PCI are a reliable predictor of EV in liver cirrhosis.