Variations in Hepatic Doppler Indices in Patients Presenting With Fatty Liver Disease: A Meta-Analysis

Objective: Fatty liver disease (FLD) affects hepatic hemodynamics, which can be assessed using Doppler indices. Understanding variations in these indices can enhance noninvasive diagnostic and monitoring tools for FLD. The aim of this review was to assess and analyze variations in hepatic artery resistive index (HARI), portal vein pulsatility index (PVPI), and portal vein velocity (PVV) in patients with FLD. Materials and Methods: This study reviewed variations in hepatic Doppler indices in patients with fatty liver disease (FLD) by analyzing peer-reviewed studies published between 2000 and 2024. A total of 52 articles were identified across several scientific databases, using Boolean operators and relevant search phrases. The meta-analysis utilized a random-effects model to account for heterogeneity, which was further assessed using chi-square tests ( p < .05) and I² statistics (low: ≤ 25%, moderate: 50%, high: ≥75%). Results: The procured data revealed that FLD patients exhibited significantly lower HARI (15% reduction), VPI (10% reduction), and PVV (25% reduction) than healthy controls ( p < .05), indicating reduced portal vein flow and increased hepatic artery flow. The liver compensated for fatty infiltrations in hepatic portal vessels by vasodilation of the hepatic arteries, increasing hepatic artery flow, and decreasing HARI. The severity of FLD in the study participant samples was found to influence Doppler indices, emphasizing their potential as noninvasive biomarkers for diagnosing and monitoring FLD. Conclusion: This literature review was focused on FLD, which has been consistently associated with reduced portal vein indices and compensatory increases in hepatic artery flow. Variations in HARI, PVPI, and PVV reflected both the hemodynamic consequences of fatty infiltration and the liver’s compensatory adaptations. It may be clinically valuable to further explore these parameters, as noninvasive biomarkers for the diagnosis, staging, and monitoring of FLD.