Related Experiment Video
Updated: Aug 15, 2026

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
[Duplex ultrasound characterization of hepatic vein blood flow in healthy probands]
U K Teichgräber1, M Gebel, T Benter
1Abteilung für Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover.
Purpose:
To characterise and standardise hepatic venous flow during the respiratory cycle in all three hepatic veins and to determine the most adequate measurement area within the vessel.
Method:
In 25 healthy subjects duplex Doppler measurements were performed of the right (RHV), middle (MHV) and left (LHV) hepatic vein. In full inspiration, mid-inspiration and expiration the maximum flow velocities of all three hepatic venous flow components (phase 1 to 3) were measured and a systolic to diastolic (S/D) ratio was determined.
Results:
In full inspiration there was a decrease of the maximum flow velocities compared to mid-inspiration (p = 0.0001). In expiration there was an increase of the maximum flow velocities (p = 0.0005). The maximum flow velocities of the MHV in mid-inspiration were -0.21 +/- 0.019 m/s (phase 1), -0.16 +/- 0.016 m/s (phase 2) and 0.08 +/- 0.011 m/s (phase 3). The S/D ratio decreases on inspiration and increases on expiration. The maximum flow velocities of the LHV differed significantly from those of the RHV and MHV. The measurements of the RHV and MHV were both reliable. Measurements from central to peripheral within the hepatic veins showed a decrease in maximum flow velocities.
Conclusion:
For standardisation of hepatic venous flow measurements the respiratory state must be determined. The most adequate area for duplex Doppler ultrasound measurements is situated about one or two centimetres from the orifice of the vena cava.
Related Concept Videos
Venous Return
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system as it...
Hepatic Portal System
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is responsible...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

