Frequency of Hemodynamic Variations in Hepatic Artery according to Grades of Non-Alcoholic Fatty Liver Disease on Doppler Ultrasound

Background: Non-alcoholic fatty liver disease is an important cause of hepatic related morbidity and mortality due to its spectrum from simple hepatic steatosis to fibrosis/cirrhosis; latter alter the hepatic vascular hemodynamics particularly of hepatic artery. Objective: To evaluate the hemodynamic variations in Hepatic artery in subjects with non-alcoholic fatty liver disease (NAFLD) on Doppler Ultrasound and correlate it with different grades of NAFLD. Methods: This hospital based observational study was done in the Department of Radiology, Dr Ruth K.M. Pfau Civil Hospital Karachi from September 2023 to August 2024. This study enrolled 139 subjects of either gender between 18-55 years of age with NAFLD according to study criteria. Then ultrasound was performed to grade the NAFLD and measure the liver span followed by Doppler ultrasound of hepatic artery to calculate resistive index (HARI). Results: There were 90 (64.7%) males and 49 (35.3%) females with mean age of 43.7 ± 9.9 years. Grade I fatty liver was more common seen in 70 (50.4%) subjects followed by grade II in 53 (38.1%) and grade III in 16 (11.5%) subjects. Liver span was increased with raising severity of fatty liver seen in 32 (23%) subjects. Hepatic artery Resistive Index decreased as the grades of fatty liver increased; HARI was 0.77 ± 0.05 in grade I, 0.72 ± 0.05 in grade II and 0.68 ± 0.03 in grade III. Conclusion: Hepatic artery RI decreases with the severity of fatty liver so Doppler ultrasound is reliable and cost effective imaging modality to assess the hemodynamic changes in hepatic artery in NAFLD patients.