title: Altered hepatic hemodynamics caused by temporary occlusion of the right hepatic vein: evaluation with Doppler US in 14 patients.
abstract: OBJECTIVE
  To evaluate with Doppler ultrasonography (US) the altered hepatic hemodynamics caused by temporary occlusion of the right hepatic vein.
  
  
  METHODS
  The study group consisted of 14 patients being considered for hepatic arterial infusion or transarterial embolization. In all patients, maximum peak velocity of the blood flow in the right portal vein was measured with Doppler US before and during the occlusion of the right hepatic vein. In 13 patients, color Doppler US was performed to evaluate Doppler signal in the portal venous branch in the occluded area before and during occlusion. Average peak velocity in the right hepatic artery in eight patients was measured by using a transducer-tipped guide wire before and during occlusion.
  
  
  RESULTS
  Maximum peak velocity of the right portal vein significantly decreased with occlusion (P <.01). Hepatic venous occlusion changed the Doppler signal in the portal venous branch in the occluded area from hepatopetal to no signal in 10 patients; to weakened hepatopetal in two; and to hepatofugal in one. Average peak velocity of the right hepatic artery showed a decrease or plateau for 15-30 seconds after the start of occlusion and then a rapid increase to reach a plateau at around 75-90 seconds, with 1.5-2 times as much velocity as that before occlusion.
  
  
  CONCLUSIONS
  Increase in hepatic arterial velocity is accompanied by a decrease in the portal velocity with temporary occlusion of the right hepatic vein; the expected increased drainage through the portal vein was almost undetectable.
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama 700-8558, Japan. radiol@cc.okayama-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Hiraki
authors.forename: S
authors.initials: S
authors.lastname: Kanazawa
authors.forename: H
authors.initials: H
authors.lastname: Mimura
authors.forename: K
authors.initials: K
authors.lastname: Yasui
authors.forename: A
authors.initials: A
authors.lastname: Tanaka
authors.forename: S
authors.initials: S
authors.lastname: Dendo
authors.forename: K
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Y
authors.initials: Y
authors.lastname: Hiraki
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D004621:Embolization, Therapeutic; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006503:Hepatic Veins / Q000502:physiology*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color