Learning objectives
Review the normal Doppler findings of the portal vein.
Outline and explain the pathological appearances of the portal vein on grey scale,
colour and spectral Doppler ultrasound.
Background
The portal vein (PV) supplies nearly 75% of blood to the liver while the hepatic arteries supply the remaining 25%.
The main PV is formed at the confluence of the superior mesenteric and splenic veins at the level of L1/L2 [1].
As it enters the liver,
the main PV bifurcates into right and left,
with the right further dividing into anterior and posterior branches,
while the left into medial and lateral branches.
The PV measures up to 12.6 + 1.7mm in diameter and nearly 8cm...
Findings and procedure details
The normal PV circulation is demonstrated in Fig. 2.
Normal portal vein waveform
Sonographically,
PV has a thick and echogenic wall.
It demonstrates antegrade flow direction (hepatopetal flow).
The normal PV waveform is described as phasic,
with minimal or gentle undulation depending on the cardiac cycle and respiration [3].
The flow velocity ranges from 16 to 40cm/sec [3-4] (Fig. 3).
Abnormal portal vein waveform
Different pathologies may affect the appearance and waveforms in a unique way.
A good grasp of the concepts and principles behind...
Conclusion
Recognition and understanding the various portal vein Doppler spectra are important in making the correct sonographic diagnosis,
which might have an impact on clinical management.
Personal information
Author details:
Ms Sim Wanjou
Senior Radiographer
Division of Rad Science,
Singapore General Hospital
Ms Azizah Mohamed Afif
Principle Radiographer
Division of Rad Science,
Singapore General Hospital
Ms Soh Qinhui
Principle Radiographer
Division of Rad Science,
Singapore General Hospital
Dr Lim Sze Ying
Consultant
Division of Rad Science,
Singapore General Hospital
References
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Determination of normal portal vein diameter on ultrasound scan among adults in northeastern Nigeria.
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Standard imaging techniques for assessment of portal venous system and its tributaries by linear endoscopic ultrasound: A pictorial essay.Endoscopic Ultrasound,2(1),
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McNaughton,
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