Today, I review, link to, and embed “Portal Vein Color & Spectral Doppler Ultrasound Normal Vs Abnormal Images | Liver Vascular USG Scan” from Dr. Sam’s Imaging Library.
All that follows is from the above resource.
Sep 7, 2023Portal Vein Color & Spectral Doppler Ultrasound Normal Vs Abnormal Images | Liver Vascular USG Scan
*Cases
- Intro – 0:00
- Portal Hypertension – 0:09
- Tricuspid Regurgitation – 5:16
- Bland Portal Vein Thrombosis – 5:57
- Malignant Portal Vein Thrombosis – 7:37
- Cavernous Transformation – 8:12
- Portal Vein Aneurysm – 8:29
Portal Hypertension:
- Hepatofugal flow: Blood flow away from the liver.
- Diminished blood flow (Reduced Velocity: Less than 15 cm/s)
- Abnormal value of PI
- Most common cause is liver cirrhosis
- To and fro flow: Alternating hepatopetal and hepatofugal blood flow
- Stagnant, low velocity flow (velocity less than 15 cm/s)
- Lack of blood flow on color doppler due to portal vein thrombosis
- Collateral veins may develop as a compensatory mechanism to bypass the high-pressure system.
- Tortuous vascular structures
Tricuspid Regurgitation: Pulsatile flow due to backflow of blood into the right atrium, affecting venous return, including that of the portal vein.
Bland Portal Vein Thrombosis:
- Hyperechoic thrombus within the lumen
- Hypoechoic thrombus within the lumen, usually seen in acute cases
Malignant Portal Vein Thrombosis
- Associated with HCC or other cancers
- The thrombus will have internal flow
- Hyperechoic/heterogeneous thrombus
Cavernous Transformation:
- Formation of collaterals around the portal vein, at the porta hepatis
Portal Vein Aneurysm: Abnormal focal dilation of portal vein Diameter: Greater than 1.5cm
