Application of CDFI and portal system pressure measurement in the study of portal hypertension hemodynamics

Abstract

It has been discovered in portal system hemodynamics research using CDFI and pressure measurement, that among 40 portal hypertension patients the demonstrating rate, of left gastric vein (LGV) was 77.5%, and all were hepatofugal. The demonstrating rates of spontaneous splenorenal vein shunt collaterals and of patency umbilical vein (UV) with blood signal were 85%, 12.5% respectively, and the thrombosis rate of portal system was 10%. Blood flow direction of main portal vein (MPV) in all patients was hepatopetal, and one case of superior mesenteric vein (SMV) and another one of splenic vein (SV) were hepatofugal. The patients with MPV thrombosis or portal system hepatofugal should be operated on by shunt. Shunt capacity of portal vein in gastrosplenic region was 34.07% on average. This demonstrated that devascularization was applicable. Internal diameter, blood capacity and time average velocity (TAV) of the left portal vein (LPV) and right portal vein (RPV) with portal hypertension were almost equal, their difference being not significant (P>0.2). This should be a basis for the diagnosis of portal hypertension. Free portal pressure (FPP) and internal diameter, blood capacity and TAV of MPV, SV, SMV, LGV were not correlative with each other.

Keywords

color Doppler flow imaging (CDFI) / time average velocity (TAV) / free portal pressure (FPP)

References

[1] MostbeckG J, WittichG H, HeroldC, et al. . Hemodynamic significance of the parambilical vein in portal hypertension: assessment with duplex US. Radiology, 1989, 170339-339

[2] FunstonM R, GouldieE, RichterI A, et al. . Ultrasound diagnosis of the recanalized umbilical vein in portal hypertension. J Clin Ultrasound, 1980, 8244-244

[3] TrigauxJ P, BeersB V, MelangeM, et al. . Alcoholic liver disease: value of the left-to-right portal vein ratio in its sonographic diagnosis. Gastrointest Radiol, 1991, 16215-215

[4] JohansenK, PaunM. Duplex ultrasonography of the portal vein. Surgical Clinics of North America, 1990, 70181-181