article · Nigerian Postgraduate Medical Journal
Chronic hepatitis B is a major driver of chronic liver conditions. Research evaluating 143 asymptomatic chronic hepatitis B patients alongside 143 matched healthy controls demonstrated that standard grayscale ultrasound showed no significant differences in liver span or echogenicity between the groups. However, hepatic artery Doppler haemodynamic measurements were significantly elevated in patients with hepatitis B, showing higher resistive index and pulsatility index values compared to controls. These Doppler indices also correlated significantly with elevated serum alanine transaminase levels and higher hepatitis B viral loads. Although conventional ultrasound appearance remained unremarkable in these asymptomatic individuals, Doppler imaging successfully identified underlying hepatic vascular changes. Consequently, hepatic artery Doppler indices show utility as non-invasive imaging biomarkers to assist in assessing and monitoring disease progression in adults with chronic hepatitis B.
Chronic hepatitis B often advances silently without visible changes on conventional ultrasound scans. Identifying reliable, non-invasive indicators that correlate with liver inflammation and viral replication enables clinicians to detect disease activity earlier. Doppler ultrasound provides an accessible method to track vascular changes in asymptomatic individuals, supporting more informed clinical management before irreversible liver damage develops.
This work points to the use of hepatic artery Doppler imaging protocols as non-invasive assessment tools for radiologists and hepatologists monitoring hepatitis B activity. The evidence is applied and tested in a clinical cohort, demonstrating utility for disease tracking. Establishing standardised cut-offs and integrating automated measurement protocols into clinical ultrasound software would represent the next steps towards routine adoption.
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BACKGROUND: Hepatitis B is a common cause of chronic liver disease. Early features of fibrosis are detectable using ultrasound and Doppler imaging. AIMS: This study evaluated relationships between hepatic artery Doppler parameters, serum alanine transaminase (ALT) and hepatitis B virus (HBV) deoxyribonucleic acid (DNA) quantification (viral load) in seropositive adults with hepatitis B compared with matched healthy controls. MATERIALS AND METHODS: A comparative cross-sectional study assessed grayscale liver ultrasound, hepatic artery Doppler indices, ALT and viral load among 143 asymptomatic hepatitis B-positive adults and matched controls. Liver size, echotexture, resistive index (RI), pulsatility index (PI), ALT and HBV DNA levels were measured. Data were summarised using mean, median and standard deviation. Chi-square and t -tests compared groups, while Pearson correlation assessed relationships among ALT, RI and PI, with significance at P < 0.05. RESULTS: The study compared 143 chronic hepatitis B (CHB) patients with 143 healthy controls. No significant differences were observed in liver span (13.0 vs. 12.8 cm) or echogenicity, but hepatic artery Doppler indices were significantly elevated in hepatitis B patients (0.69 vs. 0.61 for RI and 1.25 vs. 0.98 for PI). Elevated ALT levels and detectable viral loads were more common in patients on treatment. Doppler indices correlated significantly with ALT and the viral load, suggesting their potential role in monitoring hepatitis B progression. CONCLUSION: Doppler ultrasound remains a valuable non-invasive tool for assessing hepatic vascular changes among asymptomatic CHB-positive patients with RI and PI revealing those changes. Doppler indices correlated significantly with abnormal serum ALT and elevated viral load levels among hepatitis B-positive patients.
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DOI: 10.4103/npmj.npmj_141_26
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