Comprehensive Ultrasound Assessment of Morphological and Hemodynamic Changes in Liver Cirrhosis by Child-Pugh Class

The aim of this study was to characterize structural, hemodynamic, and elastographic changes in the liver and portal system in 267 patients with varying severity of liver cirrhosis. Gray-scale ultrasonography, Doppler assess­ment of the hepatic and splenic vessels, evaluation of portal blood-flow indices, and elastography were performed. With increasing Child–Pugh class, irregular liver contours, nodular remodeling of the parenchyma, distortion of the vascular architecture, and splenomegaly became more frequent. The portal vein diameter increased, while portal blood-flow velocity decreased; vascular resistance indices and liver stiffness rose concurrently. The strongest associ­ations with cirrhosis severity were found for the portal vein congestion index (r=0.68), portal vein diameter (r=0.64), and portal blood-flow velocity (r=−0.58). These findings support the value of comprehensive ultrasonography for assessing liver morphology and portal hemodynamics