Journal of Ultrasound in Medicine, Vol 15, Issue 10 707-713, Copyright © 1996 by American Institute of Ultrasound in Medicine
Peripheral portal venous blood flow alterations induced by hepatic masses: evaluation with color and pulsed Doppler sonography
M. A. Miller, D. M. Balfe and W. D. Middleton
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
We examined 29 patients with intra- and extrahepatic masses and 10 normal
volunteers with duplex and color Doppler ultrasonography. Portal blood flow
adjacent to the masses was categorized as anterograde, retrograde, or
nondetectable and was correlated with lesion size, character, and location.
Anterograde flow was documented in the main portal vein and in the central
right and left portal veins in all patients and volunteers. Flow in the
peripheral portal veins near the lesion examined was retrograde in 17,
anterograde in 10, and nondetectable in two of the patients. Retrograde
peripheral flow was seen only in solid lesions, abscesses, and large
subcapsular hematomas. Peripheral portal flow was anterograde in all of the
volunteers. This study confirms that color Doppler sonography can detect
alterations in portal flow induced by intra- and extrahepatic masses. The
relatively common presence of peripheral portal flow reversal in patients
with metastases and hepatocellular carcinomas indicates that it is not a
reliable sign for differentiation between these entities.
