Porta hepatis: duplex Doppler US with angiographic correlation.

Area of Science:

• Medical Imaging
• Hepatology
• Vascular Ultrasound

Background:

• Portal hypertension diagnosis relies on invasive methods.
• Non-invasive imaging like duplex Doppler ultrasonography is crucial for assessing portal venous system abnormalities.

Purpose of the Study:

• To evaluate the diagnostic accuracy of duplex Doppler ultrasonography (US) in the porta hepatis for suspected portal hypertension.
• To compare duplex US findings with panhepatic angiography.

Main Methods:

• Twenty patients with suspected portal hypertension underwent independent duplex US and panhepatic angiography.
• Hepatic arterial resistive indexes were correlated with corrected sinusoidal pressures.

Main Results:

• Duplex US agreed with angiography in 16 patients with normal portal veins and two with total thrombosis.
• Sensitivity and specificity for main portal vein disorders were 83% and 93%, respectively.
• Duplex US missed one case of partial thrombosis and two portal vein branch occlusions.

Conclusions:

• Duplex US is accurate for assessing portal vein flow direction and detecting total thrombosis.
• Partial thrombosis and some branch occlusions may not be detected by duplex US.
• Hepatic arterial resistive index is specific but not sensitive for portal hypertension.