Doppler in Portal Hypertension
Normal portal vein (PV) diameter—9–13 millimeters
Normal PV length—6–8 centimeters (splenic vein [SV] + superior mesenteric vein [SMV]) at L1, L2 level
Normal PV pressure—6–10 millimeters of mercury (mm Hg)
Normal PV velocity—12–18 centimeters per second
Normal PV blood flow—500–800 milliliters per minute
Normal flow is Hepatopetal (Figure 34.1)
PV transports blood from GIT to the liver
Figure 34.1 Depicting normal portal venous flow and waveform.
Etiology
1. Presinusoidal—Extrahepatic—PV thrombosis, compression of PV, and SV occlusion
Intrahepatic—Malignant infiltration, periportal fibrosis, and toxins
2. Sinusoidal—Cirrhosis
3. Postsinusoidal—Intrahepatic—Cirrhosis
Extrahepatic—Hepatic vein obstruction (BCS) Tumor thrombus/stenosis of IVC
Most common causes—Extrahepatic portal vein obstruction (EHPO)—45%–50%
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