Value of hepatic artery resistance index in evaluating progressive liver fibrosis in nonalcoholic fatty liver disease

Objective To investigate the changes in blood flow indices in patients with nonalcoholic fatty liver disease (NAFLD) and the value of hepatic artery resistance index (HARI) in evaluating progressive liver fibrosis. Methods A total of 148 patients who were diagnosed with NAFLD in The People's Hospital of Gong'an County from January 2016 to December 2017 and 60 healthy volunteers were selected as study subjects. Fasting venous blood samples were collected for liver function evaluation and routine blood test, and then NAFLD fibrosis score (NFS) was calculated for NAFLD patients. According to NFS, the patients with NAFLD were divided into group A (NFS ≤0. 676) and group B (NFS > 0. 676) . The healthy volunteers were enrolled as control group. Color Doppler ultrasound was performed to measure peak portal vein velocity (PPVV) , mean portal vein velocity (MPVV) , and HARI in all subjects. An analysis of variance was used for comparison of continuous data between three groups, and the SNK-q test was used for multiple comparisons; the chi-square test was used for comparison of categorical data between groups. A Spearman' s rank correlation analysis was used to investigate the correlation between assessment indices. Results There were 121 patients in group A and 27 in group B. Group B had the highest HARI (0. 88 ± 0. 05) , followed by the control group (0. 76 ± 0. 09) and group A (0. 64 ± 0. 08) , and there was a significant difference between groups (F =4. 981, P < 0. 01) . The control group had the highest MPVV (22. 84 ± 3. 12 cm/s) and PPVV (19. 02 ± 1. 97 cm/s) , followed by group A (17. 84 ± 2. 87 cm/s and 15. 29 ± 2. 02 cm/s) and group B (15. 31 ± 2. 29 cm/s and 13. 39 ± 1. 92 cm/s) , and there were significant differences between groups (F = 5. 645 and 7. 435, both P < 0. 01) . In the patients with NAFLD, HARI was positively correlated with NFS (r = 0. 763, P < 0. 01) , and MPVV and PPVV were negatively correlated with NFS (r =-0. 463 and-0. 425, both P < 0. 01) . Conclusion There are hemodynamic changes of the liver in NAFLD patients with progressive liver fibrosis. HARI can be used as a noninvasive method to evaluate whether NAFLD patients develop progressive liver fibrosis. The development of progressive liver fibrosis should be considered in case of abnormal increase in HARI.