Variability of hepatic vein Doppler tracings in normal subjects

Abstract

A prospective study was undertaken to determine the variability of hepatic vein Doppler waveforms in normal subjects. Seventy-five patients without liver or heart disease underwent Doppler examination of the middle hepatic vein. Normal triphasic tracings were observed in 68 subjects, while flattened tracings were observed in seven subjects. In addition, in four T he normal velocity curve of the hepatic vein reflects cardiac and respiratory events.t-J A triphasic pattern has been described in normal subjects, while flattening of this curve has been observed in cirrhotic patients and with the Valsalva maneuver.t--' !1 We conducted a study to determine if "abnormal" or flattened hepatic vein tracings are observed in healthy subjects. The effect of prolonged inspiration on the Doppler tracing was also studied. MATERIALS AND METHODSThe study group consisted of 75 subjects (age, 20-65 years; mean, 43 years) without liver or heart disease. All patients were examined with color flow images and pulsed Doppler tracings. Examinations were performed on a Quad 2000 (Siemens Quantum, Issa· quah, WA) or an ATL UM·9 (ATL,

Hepatic and portal vein flow pattern in correlation with intrahepatic fat deposition and liver histology in patients with chronic hepatitis C.

“…The normal triphasic Doppler sonography waveformof hepaticveinsvanesaccordingto changes in the central venous pressure. During atrial and ventricular diastole, two portions of the signal (phase I and phase II) reflect the hepatofugalflow to the heart, while during atrial contraction a third portion (phase ifi) representsa short interval of reversedflow [1,10]. Conflicting data have been reported concerning changes of the flow pattern in rela tion to chronic liver disease.…”

Hepatic vein waveforms in liver cirrhosis re-evaluated

“…With Valsalva maneuver and suspended respiration, the negative oscillation disappeared in few cases and it may be the reason of discrepancy in findings among many studies. This may be the reason why 7/75 (9.33%) subjects of Shapiro et al [1] showed flat waveform even without liver or cardiac disease. Changes in the right atrial pressure with respiratory maneuvers may be a probable cause.…”

“…Of the hepatic causes, changes in liver parenchyma have been pointed out as most probable factor that brings about the change in waveforms. However, there has also been report of changes in waveform in study population without liver and cardiovascular disease [1].…”

Focal hepatic vein stenoses in diffuse liver disease.

“…Thirty-six of the 56 patients with abnormal Doppler waveforms a•so had focal stenoses. (1) there is a type II abnormality from a non-narrowed segment, whereas on the right (2) a triphasic waveform is obtained from a stenotic segment. Peak velocity doubles.…”