Ultrasonography of portal hypertension

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Author: Mikael Häggström [notes 1]

Evaluation

Signs of portal vein hypertension are:

  • Portal vein measurement and Doppler:
  • Dilated portal vein: >13 mm (sensitivity 42%, specificity 95-100%)[1]
  • Slow portal venous flow on Doppler: <15 cm/sec[1]
  • Reversal or alternating directions of portal venous flow[1]
  • Portal venous thrombosis
  • cavernous transformation of the portal vein,[1] appearing like multiple veins.
  • Hepatic artery Doppler:
  • Increased velocity in hepatic artery[1]
  • Corkscrew appearance of hepatic arteries[1]
Doppler ultrasonography of the portal vein over 5 seconds, showing peaks of maximal velocity, as well as points of minimal velocity.
  • Superior mesenteric and splenic vein Doppler:
  • Dilated superior mesenteric vein and splenic vein of > 10mm.[1] These should be measured during deep inspiration since it may vary with respiration.[1]
  • Loss of respiratory variation in superior mesenteric vein and splenic vein on spectral Doppler[1]
  • Re-canalisation and hepatofugal paraumbilical venous flow.[1]
  • Portalisation of hepatic vein flow on Doppler[1]

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 Dr Yuranga Weerakkody, A.Prof Frank Gaillard et al.. Cirrhosis. Radiopaedia. Retrieved on 2018-06-16.
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