- To recognize the normal and abnormal appearances of the spectral waveform of the hepatic vein,
their causes and the mechanism behind their generation.
- To perform a systematic approach to the interpretation of the hepatic vein spectral tracing.
Doppler ultrasound is the first-line imaging modality for the evaluation of flow in liver vessels.
Due to the venous pressure changes during the cardiac cycle,
which generate antegrade-retrograde flow variations,
the hepatic veins (HV) have the most complex waveform of the liver.
The spectral waveform of the hepatic veins also depends on the compliance of the liver tissue and the hepatic venous resistance,
as well as physiological variants and technical factors.
Findings and procedure details
Hepatic veins (HV) are large veins that drain blood into the right atrium (RA) through the inferiorvena cava (IVC).
There are three major hepatic veins,
named the right hepatic vein,
middle hepatic vein and left hepatic vein.
The hepatic veins appear in ultrasound as thin-walled tubular anechoic structures enclosed by hepatic parenchyma.
They are best approached by a right subcostal oblique view,
allowing a good visualization of the hepatic veins lengthwise and their confluence with the IVC.
Illustration and interpretation of the HV waveform...
Radiologists should be familiar with the normal and abnormal appearances of the hepatic veins spectral tracing and their main causes.
An accurate interpretation provides valuable data that supplements Doppler sonography of the liver and often helps to establish a differential diagnosis.
Ana Nassauer Mónica,
Li Bassi S,
Liver cirrhosis: changes of Doppler waveform of hepatic veins.
Erratum in: Radiology 1991 Aug;100(2):586.PubMed PMID:1987617.
2.von Bibra H,
Diagnosis of constrictive pericarditis by pulsed Doppler echocardiography of the hepatic vein.
Am J Cardiol.
1989 Feb 15;63(7):483-8.
PubMed PMID: 2644801.
Frequency of abnormal hepatic venous waveforms in cirrhotic patients.
Pak Armed Forces...