Doppler sonographic diagnosis of severe portal vein pulsatility in constrictive pericarditis: Flow normalization after pericardiectomy

Gorka, T S; Gorka, Waldemar

doi:10.1002/(sici)1097-0096(199902)27:2<84::aid-jcu7>3.0.co;2-b

Cited by 18 publications

(6 citation statements)

References 12 publications

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“…The main factor is increased hepatic venous outflow resistance with subsequent periodic trans-sinusoidal shunting caused by the elevated right atrial pressure with periodic profuse retrograde venous drainage into the hepatic vein via the inferior vena cava 25. This condition is commonly attributed to tricuspid insufficiency, and rarely, constrictive pericarditis 26. The pattern is characterized by a monophasic hepatopetal flow with peak velocity and gradual diminution of velocity with or without a transitory hepatofugal flow velocity during each cardiac cycle; it exhibits a periodic hump-like velocity tracing.…”

Section: Discussionmentioning

confidence: 99%

Fluctuating portal velocity tracing with rhythmicity: ultrasonic differential diagnosis and clinical significance

Meng¹,

Yang²,

Fu³

et al. 2012

Radiology and Oncology

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BackgroundTo evaluate the usefulness of the routine sonographic evaluation of the pattern of fluctuate portal velocity tracings and the hepatic veins for the diagnosis of arterioportal fistula (APF) and cardiogenic trans-sinusoidal shunting (CTS).Materials and methods.Color Doppler flow imaging and pulsed-wave Doppler (PW) examinations of the portal vein were performed in 282 subjects. The waveforms of the velocity tracings in the portal main trunk and its branches were determined to infer APF or CTS. Suspected cases of APFs or CTSs were always confirmed by echocardiography, contrast-enhanced ultrasound, computed tomography, or digital subtraction angiography findings. The portal maximum velocity (Vmax), minimum velocity(Vmin), Vmax/Vmin, arterial peak systolic velocity and resistance index, and venous reverse and forward velocities were used to estimate their haemodynamics.ResultsThe waveform of the velocity tracing for the draining portal vein of APF was typically arterial-like or diphase, as indicated by a systolic hepatofugal dwarf peak and a diastolic hepatopetal low flat shape. The flow in the affected portal vein was always hepatofugal in an intrahepatic patient, whereas a hepatopetal flow was observed in an extrahepatic APF patient. The waveform of the velocity tracing for the portal vein of CTS patients, especially its intrahepatic branches, showed a typical hump-like shape with or without a transitory hepatofugal tracing. The PW results displayed an increase in the retrograde phase of the hepatic venous flow with increased velocities in the two phases.ConclusionsPortal velocity tracings should be evaluated during routine detecting for APF or CTS, especially in patients with gastrointestinal upsets.

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Section: Discussionmentioning

confidence: 99%

Fluctuating portal velocity tracing with rhythmicity: ultrasonic differential diagnosis and clinical significance

Meng¹,

Yang²,

Fu³

et al. 2012

Radiology and Oncology

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“…9 Relation of heartbeat intervals to differences in onset times between flow volume waves in the portal vein and those in the inferior vena cava after clamping the mesenteric artery Several hypotheses have been proposed concerning the source of pulsatile flow in the portal vein, but the underlying reasons have yet to be validated. Some hypotheses have been reported, attributing pulsatile flow to the effects of the hepatic artery [15,16], the inferior vena cava via the sinusoids [5,6,17], or the direct effects of surrounding organs [18].…”

Section: Discussionmentioning

confidence: 99%

Experimental evaluation of portal venous pulsatile flow synchronized with heartbeat intervals: effects of vascular clamping on portal hemodynamics

2012

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“…But cardiologists in general have remained unaware of this connection. Patients with very high central venous pressure (as manifested in IVC plethora and dilatation) have a consistently abnormal pattern of portal vein flow 11–14 . While the reasons for this have yet to be fully elucidated, it seems likely that high pressure in the IVC and hepatic veins is somehow transmitted to the portal venous system through the hepatic sinusoids.…”

mentioning

confidence: 86%

Update on Echocardiography of the Inferior Vena Cava

D'Cruz

Khouzam

2005

Echocardiography

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Doppler sonographic diagnosis of severe portal vein pulsatility in constrictive pericarditis: Flow normalization after pericardiectomy

Cited by 18 publications

References 12 publications

Fluctuating portal velocity tracing with rhythmicity: ultrasonic differential diagnosis and clinical significance

Fluctuating portal velocity tracing with rhythmicity: ultrasonic differential diagnosis and clinical significance

Experimental evaluation of portal venous pulsatile flow synchronized with heartbeat intervals: effects of vascular clamping on portal hemodynamics

Update on Echocardiography of the Inferior Vena Cava

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