Color multispectral ultrasound has been widely used in abdominal vascular examination [1-4], and cirrhosis is a common disease in China [5-17], and hemodynamic changes in the portal venous system have been reported in patients with cirrhosis [18-28]. In recent years, it has been noted that cirrhosis and chronic hepatitis also cause changes in the hepatic venous spectrum [29-35]. We made a comparative study of hepatic venous Doppler spectral waveforms in 74 patients with cirrhosis and 69 healthy individuals and report it as follows. 1. materials and methods 1. 1 Materials 74 patients with cirrhosis hospitalized in 1999-01/2000-07, 55 males and 19 females, aged 25 to 78 years, average 53 years, were diagnosed with cirrhosis by clinical, biochemical, ultrasound, CT or MRI and gastroscopy, including 62 cases of viral (after hepatitis B infection) and 12 cases of alcoholic, and 57 of these patients were performed Child-Pugh score, grade A (5-6 points) in 29 cases, grade B (7-9 points) in 17 cases, and grade C (≥10 points) in 11 cases. In the control group, there were 69 healthy individuals, 51 males and 18 females, aged 22-74 years, with a mean of 52 years. All patients with cirrhosis were free of heart failure and had normal ECG. 1, 2 Methods A HITACHI EUB-555G color multispectral ultrasound diagnostic instrument with a probe frequency of 3.5 MHz was used. patients fasted >8 hours before the examination. During the examination, the patient was lying supine, the probe was cut obliquely under the right rib margin upward to show the hepatic vein and the second hepatic hilar, and after the middle hepatic vein was clearly displayed, the sampling volume was placed at 3-5 cm from the middle hepatic vein to the inferior vena cava, the angle of the acoustic beam was less than 50°, and the patient was calm at the end of inspiration and breath-holding to show a stable Doppler spectrum for recording. Referring to the Bolondi method [29], the hepatic vein Doppler spectrum was classified into 3 types. (i) type 0 (HV0): three-phase wave or four-phase wave, i.e. two negative waves with one or two positive waves; (ii) type I (HV1): biphasic wave with reduced amplitude and no reverse flow; (iii) type II (HV2): continuous flat wave, similar to portal flow spectrum. Also refer to Bolondi [29] and Arda et al [30] method to designate HV0 waveform as normal waveform and HV1 and HV2 waveform as abnormal waveform. Statistical treatment The examination results were statistically analyzed by X2 test. 2, Results The hepatic vein spectrum was type 0 in all healthy controls. In patients with cirrhosis, there were 21 cases (28%) with normal hepatic vein spectrum (type 0) and 53 cases (72%) with abnormality, including 40 cases (54%) with type I and 13 cases (18%) with type II, and there was a significant difference between the two groups (P<0.01=). There was no significant difference between patients with cirrhosis of different etiologies. According to Child-Pugh classification, the most severe liver function impairment was found in the HV2 group, while the least severe liver function impairment was found in the HV0 group. There was no significant difference in the overall detection rate of abnormal hepatic vein spectrum (type I or type II) in patients with different Child-Pugh grades, but the detection rate of type II spectrum was highest in patients with Child-Pugh grade C, which was significantly different from the ratio of grade A and B, while there was no significant difference between the ratio of grade A and B (Table 1). 3, Discussion In normal subjects, the hepatic vein has a thin and supple wall, and the multispectral spectrum shows a three- or four-phase waveform (two negative and one or two positive waves). This waveform is produced by the difference in central venous pressure due to cardiac systole and diastole and is similar to the waveform of the jugular vein. Abnormalities in the hepatic venous spectrum can occur in many different diseases, such as severe fatty liver, Budd-Chiari syndrome [36-38], heart failure, constrictive pericarditis, tricuspid valve insufficiency, etc. In 1989, Hosoki et al [38] reported the disappearance of hepatic venous spectrum fluctuations in patients with Budd-Chiari syndrome and recommended this as the main criterion for the diagnosis of Budd-Chiari syndrome. Chiari syndrome as the main criterion for the diagnosis of Budd-Chiari syndrome. In 1991, Bolodi et al [29] reported that hepatic vein spectrum changes were associated with cirrhosis, and about 50% of cirrhotic patients showed low amplitude non-inverted waves or completely flat waves, of which the latter accounted for 18.3%, the basic mechanism of such waveforms may be: (i) related to the degree of liver fibrosis, which decreases liver compliance and leads to weakened hepatic venous pulsation Colli et al [31] also found that cirrhosis can cause changes in the hepatic vein Doppler spectrum with a sensitivity of 75%, and concluded that abnormalities in the hepatic vein spectrum are significantly associated with liver tissue fibrosis and steatosis. Both authors concluded that changes in hepatic venous spectrum can be caused not only by hepatic venous return disorders but also in diffuse lesions of the liver parenchyma. Hepatic vein Doppler spectroscopy can reflect the hemodynamic changes of diffuse liver lesions more sensitively and has some significance in estimating the severity and prognosis of the disease, and studies by Bolodi et al [29] and Ohta et al [32] both concluded that hepatic vein spectral waveform changes were significantly associated with Child-Pugh scores, and Ohta et al [33] also reported that right hepatic vein spectral waveform correlated with survival in patients with cirrhosis. In our group of cases, 74 patients with cirrhosis, 53 cases (72%) had abnormal hepatic vein spectrum, which was close to the report of Colli et al [31], while no abnormal spectrum was found in healthy individuals, indicating that the occurrence of changes in hepatic vein spectrum is one of the important bases for the diagnosis of cirrhosis, and there was no significant difference in abnormal hepatic vein spectrum in patients with cirrhosis from different etiologies. It also showed that the degree of liver function damage was the most severe in the HVII group and the least severe in the HV0 group, suggesting that the change of hepatic vein spectrum waveform was significantly correlated with Child-Pugh score, which has some significance for estimating the severity of the disease. In recent years, it has been suggested that changes in hepatic vein spectrum can help to make a timely diagnosis of chronic liver disease at an early stage, Arda et al [30] observed 30 patients with early chronic substantial liver disease (Child-Pugh class A), 22 of whom had abnormal hepatic vein spectrum, and a domestic study [34] showed that both hepatic vein diameter and Doppler spectrum changes were correlated with the degree of liver fibrosis, in addition In addition, Doppler spectral changes in hepatic veins were also related to the size of the canal diameter, and the spectral pattern of those with narrow canal diameter was prone to abnormalities.