Radiological assessment of chronic liver disease and portal hypertension through ultrasound and Doppler imaging in the Bundelkhand region

Background: Chronic liver disease (CLD) is a progressive condition with major global health implications, especially in resource-limited regions such as Bundelkhand. Portal hypertension, a frequent complication of CLD, significantly impacts morbidity. Ultrasonography combined with Doppler imaging offers a non-invasive, affordable, and accessible method for evaluating hepatic parenchyma and hemodynamics, which is crucial for early diagnosis and management. Aims and Objectives: To identify ultrasonographic features of CLD, assess Doppler parameters of portal hypertension, correlate imaging findings with Child-Pugh classification, and determine common etiological factors of CLD in the Bundelkhand population. Materials and Methods: A prospective observational study was conducted on 100 CLD patients using ultrasound and Doppler imaging at a tertiary center. Liver morphology, portal vein parameters, and collaterals were assessed and correlated with Child-Pugh scores. Statistical analysis was performed, and ethical clearance was obtained from the institutional ethics committee. Results: In this prospective observational study involving 100 patients, the most common etiologies of CLD were alcohol (45%), hepatitis B (20%), and hepatitis C (15%). Ultrasound findings included coarse hepatic echotexture (78%), liver shrinkage (72%), irregular liver surface (66%), splenomegaly (65%), and ascites (50%). Doppler findings revealed portal vein diameter >13 mm in 60%, reduced flow velocity in 58%, hepatofugal flow in 18%, collateral formation in 40%, and reversed splenic flow in 22% of patients. A statistically significant correlation was observed between worsening Child-Pugh class and increasing portal vein diameter (P<0.001) as well as declining portal flow velocity (P<0.001). Conclusion: Ultrasound with Doppler is an effective and reliable tool for assessing CLD and portal hypertension, especially in low-resource settings. Doppler parameters correlate significantly with disease severity and may serve as prognostic indicators.