To explore the clinical value of color Doppler ultrasound (CDUS) detection of portal vein congestion index (PV-CI) and splenic vein hemodynamic parameters [main splenic vein diameter (SVD), mean splenic vein velocity (SVV), and splenic vein blood flow volume (SVQ)] in the risk assessment of esophageal and gastric fundus varices (EGFV) in liver cirrhosis.

A retrospective analysis was conducted on the medical records of 70 patients with liver cirrhosis admitted to NO. 215th Hospital of Shaanxi Nuclear Industry from March 2022 to March 2025. All underwent CDUS examination to measure PV-CI, SVD, SVV, and SVQ, and gastroscopy was performed to confirm the presence of EGFV and assess its severity. Based on endoscopic findings, patients were categorized into an EGFV group (n=42) and a non-EGFV group (n=28), the EGFV group was further subdivided by variceal severity into mild group (n=15), moderate group (n=17), and severe group (n=10). The EGFV group underwent 12-month follow-up to record esophageal and gastric variceal bleeding (EVB), categorizing patients into bleeding group (n=25) and non-bleeding group (n=17). Differences in parameters across groups were compared. Receiver operating characteristic (ROC) curve analysis was used to evaluate the efficacy of individual parameters and combined assessment in predicting EVB.

The PV-CI, SVD and SVQ in the EGFV group were significantly higher than those in the non-EGFV group, and the SVV was significantly lower than that in the non-EGFV group (P<0.05); the aggravation of EGFV degree, PV-CI, SVD and SVQ gradually increased, while SVV gradually decreased, there were statistically significant differences between the severe group and the mild and moderate groups (P<0.05); the PV-CI, SVD and SVQ in the bleeding group were significantly higher than those in the non-EGFV group, and the SVV was significantly lower than that in the non-bleeding group (P<0.05); the ROC curve showed that the area under the curve (AUC), sensitivity and specificity of the combined assessment of EVB by PV-CI, SVD, SVQ and SVV were significantly higher than those detected separately by each index (P<0.05).

The PV-CI and splenic venous hemodynamic parameters detected by CDUS are closely related to the occurrence, severity and EVB risk of liver cirrhosis EGFV, the combined assessment can improve the predictive efficiency of EGFV risk and provide a non-invasive and convenient assessment reference basis for clinical practice.