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Noninvasive Vascular Diagnosis pp 1–28Cite as

Color Duplex Scanning of the Hepatoportal Circulation

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Abstract

Doppler assessment of blood flow through the liver has become an important clinical tool for evaluating abnormalities of the liver. Alterations in flow patterns in the portal and hepatic vessels can provide important information about the anatomy, physiology, and pathology of the liver and cardiovascular system. As a result, liver Doppler has become part of the evaluation of any patient with known or suspected liver disease. Proper equipment and techniques are required for adequate evaluation of hepatic blood vessels.

The hepatic artery supplies 25–30% of the blood flow to the liver; however, this amount may be diminished in patients with celiac artery disease or increased in the setting of diminished portal venous flow.

The portal vein carries 70–75% of the blood flow to the liver. Flow patterns in the portal vein may be altered with liver disease or cardiac disease. Portal hypertension is the most common abnormality of the portal venous system and can lead to diminished, absent or reversed portal venous flow. The portal vein may also become thrombosed with portal hypertension, tumor invasion, or other disease states complicated by hypercoagulability.

The hepatic venous waveform is typically multiphasic. Altered liver parenchyma can cause a dampened or monophasic waveform, while cardiac disease can cause exaggeration of the retrograde components of the cycle. Occlusion or thrombosis of hepatic veins can lead to parenchymal changes in the liver and, ultimately, to portal hypertension.

The Doppler findings in the hepatic arteries, portal veins, and hepatic veins provide important clues to pathology affecting the liver. In addition, Doppler interrogation of these vessels can be used to monitor patients with known liver pathology to assess progression of disease and determine when interventions may be required.

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Author information

Authors and Affiliations

  1. Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Carol B. Benson & Mary C. Frates

Authors
  1. Carol B. Benson
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  2. Mary C. Frates
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Corresponding author

Correspondence to Carol B. Benson .

Editor information

Editors and Affiliations

  1. Department of Surgery, West Virginia University, Charleston, WV, USA

    Ali F. AbuRahma

  2. Johns Hopkins University, Baltimore, USA

    Bruce A. Perler

Section Editor information

  1. Department of Surgery, Division of Vascular Surgery & Endovascular Therapy, The John Hopkins University School of Medicine, Baltimore, Maryland, USA

    Bruce A. Perler M.D., M.B.A.

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Benson, C.B., Frates, M.C. (2021). Color Duplex Scanning of the Hepatoportal Circulation. In: AbuRahma, A.F., Perler, B.A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-030-49616-6_48-1

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  • DOI: https://doi.org/10.1007/978-3-030-49616-6_48-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-49616-6

  • Online ISBN: 978-3-030-49616-6

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