Pseudoportal Doppler signal in the partially obstructed inferior vena cava.
The Doppler spectrum of the normal inferior vena cava (IVC) shows a majority of flow toward the right atrium, with wide variations in flow velocity and direction owing to effects of the cardiac and respiratory cycles. Seventeen subjects underwent duplex sonography: nine children after liver transplantation, two children with right upper quadrant neuroblastoma, and six healthy control subjects. In six children the spectrum obtained from the IVC bore a strong resemblance to the unidirectional, low-velocity, continuous-flow pattern associated with the portal vein; these children included two children with biliary atresia and cirrhosis, two liver transplant recipients, and two children with IVC compression by neoplasm. In healthy children and adults, a pseudoportal Doppler signal in the IVC can be generated by subcostal right upper quadrant compression. The pseudoportal IVC appears to be a sign of partial IVC obstruction. Knowledge of this potential pitfall and meticulous morphologic imaging can help prevent mistaking the IVC for a patent portal vein.
Keller
M S
MS
Department of Diagnostic Imaging, Yale University School of Medicine, New Haven, CT 06510.
Taylor
K J
KJ
Riely
C A
CA
D000328:Adult; D001656:Biliary Atresia / Q000473:pathology / Q000503:physiopathology; D001783:Blood Flow Velocity; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008297:Male; D011169:Portal Vein / Q000473:pathology / Q000503:physiopathology*; D012039:Regional Blood Flow; D014463:Ultrasonography; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000473:pathology* / Q000503:physiopathology