Portal Htn New

7/23/2019 Portal Htn New

http://slidepdf.com/reader/full/portal-htn-new 1/48





• PORTAL VEIN LENGTH- 6-8 cm

• CALIBER- 9-13 mm

•

FLOW DIRECTION- HEPATOPETAL• VELOCITY- 15-18 cm/s

• PATTERN- UNDULATING

VARIE! WITHRE!PIRATION AND

CARDIAC PUL!ATION



• PORTAL HYPERTEN!ION

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INTRAHEPATIC PORTAL HTN

VA!CULAR EVALUATIONPORTAL VEIN DIA=ETER

PORTAL FLOW DIRECTION

PORTAL VELOCITY AND WAVEFOR=!

PRE!ENCE OF COLLATERAL!HEPATIC VEIN EVALUATION

HEPATIC AND != ARTERIE! CHANGE!



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• ARTERIAL EVALUATION

•

HEPATIC ARTERY RI AND PI - M IN CLD• H?A DIA!TOLIC VEL? PV PEA VEL?

PARENCHY=AL LIVER D!?

•

IN CIRRHO!I!- NOR=AL PO!T-PRANDIAL M IN RI I! AB!ENT

• IN CIRRHO!I!-!=A PI- PO!T-PRANDIAL IN RI- AB!ENT !#A- RI$( PI- M



• ARTERIAL EVALUATION

• CONGE!TIVE INDEQ- CRO!!!ECTIONAL AREA =EAN VEL? OF PV

• C?I- 7?13 cmSs"c PHTN

• LIVER VA!CULAR INDEQ-PV VEL? H?API

• L?V?I- 1 cm/s PHTN



• HEPATIC VENOU! EVALUATION INCIRRHO!I!- ALTERED WAVEFOR=!WITH FLATTENING OF PHA!IC

O!CILLATION!



• ORGAN EVALUATION

• LIVER CIRRHO!I!-

• NCPF-

• !PLEEN !PLENO=EGALY

• A!CITE!



• PRE-HEPATIC PORTAL HTN

• PV OCCLU!ION-

• NON- VI!UALI!ATION OF PV

• ECHOGENIC INTRALU=INAL =ATERIALCAVERNOU! TRAN!FOR=ATIONINTRAHEPATIC COLLATERAL!

• !#V AND !=V OCCLU!ION-

• HEPATOPETAL FLOW IN PV

• COLLATERAL



• PO!T-HEPATIC PORTAL HTN

• BUDD-CHIARI !YNDRO=E

• !PECIFIC !IGN!-

• ()(- '&s*$&s$%&)( )4 '"&(s

• :+)*s c)+

•

%2+)m)s&s• s%"()s&s

• IVC "



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Portal Htn New