[Duplex sonography of the splenoportal axis]

48 patients with partial or complete portal vein thrombosis or tumor stenosis were examined by pulsed Doppler duplex scanning. In addition to the analysis of morphological changes, the pulsed Doppler duplex system yields functional data on the acceleration of blood flow in stenosis, flow in partial thrombosis and in differentiation between tubular cystic structures like arterial vessels, venous collaterals and dilated bile ducts. Qualitative and quantitative measurements of portal blood flow were performed in 55 cirrhotics and 15 healthy volunteers. Portal venous velocity and portal venous blood flow were significantly reduced in patients with cirrhosis. In 46 cases a hepatopetal blood flow was shown. In five cases a hepatofugal flow and in four cases a stagnant flow was found in the portal vein. Spontaneous portal systemic collaterals with hepatofugal flow were shown in 41% of cases. 11 patients with surgical portacaval shunts were examined. Patency was demonstrated in five patients where the anastomotic site was visible. Pulsed Doppler duplex sonography proved a valuable tool in the assessment of morphologic changes and revealed qualitative and quantitative data of portal venous hemodynamics.