Hepato-mesenteric index: A new Doppler index in the hepatic perfusion’s study. Comparison with Doppler perfusion index

Purpose: to evaluate the diagnostic capabilities of a new Doppler index, the Hepato-Mesenteric Index (HMI), in the study of hepatic metastases from large bowel tumours and to compare it with Doppler Perfusion Index (DPI). Materials and methods: HMI is calculated from the ratio between the hepatic artery’s flow and the mesenteric artery’s one. 130 patients affected by colorectal carcinoma with or without hepatic metastases, underwent hepatic ultrasonographic examination. HMI and DPI were obtained and compared. 50 patients without intestinal and hepatic disease represented the control group. Results: Indexes analysis enabled identification of three groups of patients. Group A: 41/130 patients (31.5%) with hepatic metastases showing HMI and DPI higher than 0.50 and 0.30 respectively. Group B 24/130 patients (18.5%) without hepatic lesions showing HMI and DPI higher than 0.50 and 0.30 respectively. Group C 65/130 patients (50%) without hepatic metastases showing HMI and DPI lower than 0.50 and 0.30 respectively. Control group’s patients showed HMI and DPI lower than 0.50 and 0.30 respectively. These results show a perfect match between DPI and HMI. HMI is easier to calculate than DPI. DPI evaluation shows some difficulties owing to portal vein’s elliptic section and its movements with respiratory excursion. Conclusion: HMI is easy to perform, owing to its reproducibility it could replace DPI in the hepatic evaluation of patients with colorectal cancer.