Portal vein pulsatility in normal and cirrhotic adults without cardiac disease

The literature indicates that Doppler demonstration of pulsatile flow in the portal vein suggests heart disease, and that retrograde transsinusoidal transmission of atrial pulsations is the mechanism. We noninvasively investigated portal vein pulsatility (PVP) in normal subjects and in patients with cardiac and liver disease, and performed invasive studies in cirrhotic humans and normal pigs. We found that accentuated PVP occurred in some normal subjects and in some patients with cirrhosis, and that mechanisms other than transsinusoidal transmission of atrial pulsations contributed to PVP. Determinants of PVP may include pulsatile portal inflow, transmission of pulsations from the vena cava (IVC) and location of the Doppler sample volume relative to the IVC. © 1995 John Wiley & Sons, Inc.

[1]  B. Koneru,et al.  Budd–Chiari syndrome due to hepatic venous web: Rapid color Doppler diagnosis , 1993, Journal of Clinical Ultrasound.

[2]  M. Abu-Yousef.  Normal and respiratory variations of the hepatic and portal venous duplex Doppler waveforms with simultaneous electrocardiographic correlation , 1992, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[3]  L. Bolondi,et al.  Diagnosis of Budd-Chiari syndrome by pulsed Doppler ultrasound. , 1991, Gastroenterology.

[4]  M. Abu-Yousef,et al.  Pulsatile portal vein flow: a sign of tricuspid regurgitation on duplex Doppler sonography. , 1990, AJR. American journal of roentgenology.

[5]  A. Duerinckx,et al.  The pulsatile portal vein in cases of congestive heart failure: correlation of duplex Doppler findings with right atrial pressures. , 1990, Radiology.

[6]  T. Kozuka,et al.  Portal blood flow in congestive heart failure: pulsed duplex sonographic findings. , 1990, Radiology.

[7]  T. Kozuka,et al.  Hepatic venous outflow obstruction: evaluation with pulsed duplex sonography. , 1989, Radiology.

[8]  R. Busuttil,et al.  Budd-Chiari Syndrome: The Results of Duplex and Color Doppler Imaging , 1989, AJR. American journal of roentgenology.

[9]  C. Riely,et al.  Pseudoportal Doppler signal in the partially obstructed inferior vena cava. , 1989, Radiology.

[10]  B. Goldberg,et al.  Iatrogenic aneurysmal portal‐hepatic venous fistula. Diagnosis by color Doppler imaging. , 1988, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[11]  M. Lafortune,et al.  Duplex Doppler examination in portal hypertension: technique and anatomy. , 1987, AJR. American journal of roentgenology.

[12]  J. Woodcock,et al.  Blood flow in deep abdominal and pelvic vessels: ultrasonic pulsed-Doppler analysis. , 1985, Radiology.

[13]  D. Dail,et al.  Arterioportal communications: observations and hypotheses concerning transsinusoidal and transvasal types. , 1982, Radiology.

[14]  A. Woods,et al.  Ligation of hepatic and splenic arteries in treatment of cirrhosis with ascites. , 1953, Journal of the American Medical Association.

[15]  M. First,et al.  Ligation of the hepatic and splenic arteries for advanced periportal cirrhosis. , 1953, Surgery.

[16]  J A Zagzebski,et al.  Spectral and color Doppler artifacts. , 1992, Radiographics : a review publication of the Radiological Society of North America, Inc.

[17]  M. Abu-Yousef,et al.  Duplex Doppler sonography of the hepatic vein in tricuspid regurgitation. , 1991, AJR. American journal of roentgenology.

[18]  J. Hoefs,et al.  Hepatofugal portal flow in cirrhosis: Observations on hepatic hemodynamics and the nature of the arterioportal communications , 1988, Hepatology.