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Use of Duplex Doppler Sonography and Color Flow Imaging to Demonstrate Hemodynamic Changes in Portal Circulation Before and After Portosystemic Shunts

Diagnostic Ultrasound Program, Seattle University; Department of Radiology, Harborview Medical Center at Seattle, Washington.

Colleen C. Elerick, BS, RDMS

David W. Green, RDMS

Department of Radiology, Harborview Medical Center at Seattle, Washington.

Felicia E. Cummings, MD

Department of Radiology, Harborview Medical Center at Seattle; University of Washington Hospital, Seattle, Washington.

The objective of this study is to demonstrate the feasibility, usefulness, and efficacy of duplex Doppler ultrasound and color flow imaging (CFI) in assessing hepatic vessel patency, blood flow direction, and quantitative estimation of blood flow velocities, before and after placement of a transjugular intrahepatic portosystemic shunt (TIPSS). Doppler ultrasound is a reliable method of evaluating vessel and shunt hemodynamics, and is also noninvasive. In this limited study, Doppler provides a noninvasive technique for estimating portosystemic pressure gradients; and these Doppler-derived measurements are correlated to data obtained by angiography, using angiography as the gold standard.

Key Words: transjugular intrahepatic portosystemic shunt • portal hypertension • Doppler • blood flow • hemodynamic changes

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