<b>Evaluation of Hemodynamic Changes in Portal Hypertension and Their Correlation with Splenomegaly Using Doppler Ultrasonography</b>

Background: Portal hypertension produces structural and haemodynamic alterations in the portal and splenic circulations, frequently resulting in splenomegaly. Doppler ultrasonography enables non-invasive assessment of these changes. Objective: To evaluate associations between Doppler-derived portal haemodynamic parameters and spleen length in adults with portal hypertension and splenomegaly. Methods: This cross-sectional study included 53 adults recruited through convenience sampling from the radiology department of Al Razi Institute, Lahore. Portal vein diameter, portal vein velocity, portal flow, portal vein pulsatility index, portal vein resistance index, splenic vein flow velocity, hepatic artery resistance index, and spleen length were assessed. Pearson and Spearman correlations and multiple linear regression were performed using SPSS version 25.0. Results: Mean age was 51.83 ± 8.21 years, and 31 participants (58.5%) were male. Mean spleen length was 14.94 ± 1.37 cm. Spleen length correlated positively with portal vein diameter (r = 0.981; 95% CI: 0.967–0.989) and negatively with portal vein velocity (r = −0.978; 95% CI: −0.987 to −0.962), splenic vein velocity (r = −0.976), and portal flow (r = −0.975); all p < 0.001. The regression model explained 97.3% of variance in spleen length, although predictors were highly collinear. Portal vein diameter remained independently associated with spleen length (B = 0.509; 95% CI: 0.231–0.787; p = 0.001). Conclusion: Spleen length was strongly associated with multiple Doppler parameters, particularly portal vein diameter. These findings require cautious interpretation and independent validation because of severe multicollinearity and the small single-centre sample