Diagnostic ultrasound ( PDFDrive )

CHAPTER 51 The Pediatric Liver and Spleen 1755
A
B
FIG. 51.25 Normal Liver and Right Hepatic Artery (RHA) in an Infant. Oblique subcostal color Doppler sonograms. (A) Right portal vein
(RPV). (B) Cursor in RHA shows normal arterial low waveform. Doppler shifts from normal hepatic artery and portal vein have identical directions
of low.
A
B
FIG. 51.26 Postfontan Procedure Hepatic and Portal Venous Flow Increase in a Child With Congenital Heart Disease. (A) Highly pulsatile
hepatic venous low and (B) portal venous low. Right atrial pressure is transmitted through the hepatic veins, across the hepatic sinusoids to the
portal vein.
pulsatile or to-and-fro low in the portal vein may also be seen
in right-sided heart failure (Fig. 51.26) or tricuspid insuiciency,
resulting from transmitted pressure across the hepatic
sinusoids.
Abnormal Hepatic Arterial Doppler Patterns
Absence of a hepatic artery Doppler signal suggests arterial
thrombosis, spasm, or reduced low in prethrombotic states. 69
Locally increased systolic Doppler shits or peripheral tardusparvus
curves may be the result of stenosis or spasm of the
hepatic artery, as at any other arterial site.
he portal vein and hepatic artery act in concert to nourish
the liver. Changes in low volumes in one afect the other. Ater
a meal, portal venous low increases and hepatic arterial low
diminishes, probably by vasoconstriction. Postprandially, hepatic
arterial diastolic low is decreased and systolic peaks are lower