Intrahepatic portosystemic venous shunts: Color Doppler sonography.
BACKGROUND
The aim of the study was to evaluate intrahepatic portosystemic venous shunts (IPSVS) patterns and to determine the role of Color Doppler sonography in the diagnosis and evaluation of related hemodynamic changes in portal perfusion.


METHODS
Sonography and Color Doppler imaging were performed in nine patients with IPSVS. Type and Doppler waveform of the shunt were determined; velocity measurements in the portal trunk and portal branches were studied to evaluate the effects of the shunt on intrahepatic circulation. Computed tomography was performed in six patients, magnetic resonance imaging in three patients, and angiography in two patients.


RESULTS
The shunt between the portal and hepatic veins was aneurismal in six patients, while localized peripheral shunt with multiple tortuous vessels in one hepatic segment was observed in three patients. The shunts showed continuous low velocity spectral tracings and in the aneurismal shunts a low velocity bi-directional or helicoidal flow was detected. The feeding portal branches and the draining hepatic veins showed anomalous Doppler tracings and alterations of intrahepatic portal perfusion were observed in three cases.


CONCLUSIONS
Color Doppler is essential for proper diagnosis of IPSVS and for evaluation of related hemodynamic changes in portal perfusion.
De Gaetano
Anna Maria
AM
Department of Radiology, A. Gemelli University Hospital, 8, Largo F. Vito, Rome 00168, Italy. adegaetano@rm.unicatt.it
Rinaldi
Pierluigi
P
Barbaro
Brunella
B
Mirk
Paoletta
P
Di Stasi
Carmine
C
Gui
Benedetta
B
Maresca
Giulia
G
Bonomo
Lorenzo
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging*; D003097:Collateral Circulation; D005260:Female; D006503:Hepatic Veins / Q000002:abnormalities*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000002:abnormalities*; D018615:Ultrasonography, Doppler, Color