Portal Vein Doppler Velocimetry as a Non-Invasive Tool for Assessing Liver Fibrosis in Hepatic Steatosis: A Comparative Study from Nnewi, Nigeria

Abstract

Background: Hepatic steatosis is a major global health burden, often progressing to fibrosis, cirrhosis, and hepatocellular carcinoma. Liver biopsy remains the gold standard for fibrosis assessment, but its invasiveness limits its widespread use. Portal vein Doppler velocimetry and Serum biomarkers, such as the Aspartate Aminotransferase to Platelet Ratio Index (APRI), which provides biochemical insight, offer a non-invasive alternative for detecting hemodynamic changes associated with fibrosis.
Objective: To evaluate the correlation between portal vein Doppler velocimetry parameters and serum biomarkers of liver fibrosis in patients with hepatic steatosis, compared with apparently healthy controls in Nnewi, Nigeria.
Methods: A comparative cross-sectional study of 180 participants (90 with hepatic steatosis, 90 healthy controls) was conducted at Nnamdi Azikiwe University Teaching Hospital, Nnewi. Doppler parameters, including Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV), and Portal Vein Pulsatility Index (PVPI), were measured. Serum biomarkers (AST, platelet count, APRI score) were analysed.
Results: Hepatic steatosis patients showed increased portal vein diameter (1.7 mm; 95% CI: 1.39–2.01) and PVPI (0.10; 95% CI: 0.081–0.119), with reduced PSV (−4.9 cm/s; 95% CI: −7.07 to −2.73) and EDV (−2.3 cm/s; 95% CI: −3.28 to −1.32) (p < 0.001). PSV decreased and PVPI increased with steatosis severity (p = 0.002 and p < 0.001). AST and APRI were higher, while platelet counts were lower (p < 0.001). PSV correlated inversely with APRI (r = −0.243, p = 0.022).
Conclusion: Portal vein Doppler velocimetry demonstrates significant alterations in hepatic steatosis and correlates with serum biomarkers of fibrosis. It represents a promising, cost-effective, non-invasive tool for fibrosis assessment in resource-limited settings.