To Evaluate The Role of Congestive Index, Splenoportal Index and Liver Vascular Index Using Doppler Ultrasound in Clinically Suspected Cases of Portal Hypertension

Abstract Objectives: Portal hypertension is a major complication of chronic liver disease, associated with ascites, variceal bleeding, and hepatic encephalopathy. Although hepatic venous pressure gradient (HVPG) measurement is the gold standard for diagnosis, its invasive nature limits widespread use. This study evaluates the diagnostic utility of non-invasive Doppler ultrasound-derived indices—Congestive Index (CI), Splenoportal Index (SPI), and Liver Vascular Index (LVI)—in detecting portal hypertension. Methods: A comparative cross-sectional study was conducted on 100 patients with clinically suspected portal hypertension and 100 matched healthy controls at Gandhi Medical College and Hamidia Hospital, Bhopal, between May 2023 and November 2024. Doppler ultrasound assessed portal, splenic, and hepatic vascular parameters. Pearson/Spearman correlation, Mann–Whitney U test, and ROC analysis were used. Data were analysed using SPSS v23.0; significance was set at p < 0.05. Results: No significant association was found between age, gender, and portal hypertension (p = 1.000); 13% had haematemesis or varices.Portal vein parameters were significantly altered: diameter (1.52 vs. 1.13 cm), velocity (14.41 vs. 15.35 cm/s), PI (0.33 vs. 0.42), CI (0.13 vs. 0.07); hepatofugal and pulsatile flow were more frequent (all significant).Splenic vein diameter, index, velocity, and SPI were elevated (p < 0.001); 5% had pulsatile flow (p = 0.024).Hepatic artery PI was higher (1.47 vs. 0.64) and LVI lower (9.83 vs. 24.20) (p < 0.001).CI, SPI, LVI correlated strongly (r ≈ ±0.866); cut-offs yielded ≥97.5% accuracy. Conclusion: The high diagnostic accuracy of these Doppler-derived indices, especially LVI, highlights their value as accessible, cost-effective tools for non-invasive evaluation of portal hypertension.