title: Portal blood flow via the peribiliary vascular plexus demonstrated by contrast-enhanced ultrasonography with Sonazoid.
abstract: OBJECTIVE
  We report two cases in which portal blood flow via the peribiliary vascular plexus (PBP) was clearly demonstrated using contrast-enhanced intra-operative ultrasonography (CE-IOUS).
  
  
  METHODS
  Two patients who underwent hemihepatectomies were investigated using CE-IOUS. Before injection of the contrast medium, both the hepatic arterial and portal venous flows of the hemiliver to be resected were interrupted by ligating those corresponding vessels at the hepatic hilum. Subsequently, the perfluorobutane microbubbles were injected intravenously.
  
  
  RESULTS
  In the early vascular phase, a remarkable intermittent flow was visualized in the lumen of the portal branches whose inflows were interrupted. The flow of the portal vein then disappeared as a result of ligating the hepatic duct concomitantly with the surrounding connective tissue. We considered that the portal venous flow appearing under the condition of total disruption of original inflow was supplied from the hepatic artery through the PBP.
  
  
  CONCLUSIONS
  This is the first report of blood flow via the PBP in human liver visualized by dynamic image study.
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Uchikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitamura
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Miyagawa
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D006498:Hepatectomy; D006801:Humans; D007501:Iron; D008102:Liver Circulation / Q000502:physiology*; D008113:Liver Neoplasms / Q000503:physiopathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010087:Oxides; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology*; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron