Ultrasound of the liver at the hepatic hilum with color Dopp | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Ultrasound of the liver at the hepatic hilum with color Doppler interrogation of the main portal vein shows a heterogeneous appearance of the liver with multiple small echogenic foci and a spikelike wave pattern of the portal vein waveform.

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Why you should join Figure 1

74 yo male patient was sent to surgery with known HCC. Before resection we perform PVE (portal vein embolisation) to increase the volume and the function of the FLR (future liver remnant). Starting and finishing images of the portal system.

CT scan of the abdomen showing a huge pyogenic liver abscess. The etiology in this patient was ascending septic emboli from appendicitis in which the infection traveled from the superior mesenteric vein (SMV) to the hepatic portal vein seeding the liver.

As seen on previous US and MR images, Portal venography obtained with catheter tip in the main portal vein demonstrates intrahepatic porto-hepatic venous fistulas with associated aneurysms.(red arrows) Embolization of the portal branches communicating with the right hepatic veins was performed using Amplatzer vascular plugs (St Jude Medical, Plymouth, MN, USA). Doppler US study of the liver performed one month after embolization demonstrates continued occlusion of the portohepatic communications with associated aneurysms.

Anatomic segments of the liver. A series of axial postcontrast CT images demonstrating the anatomic landmarks and segmental anatomy of the liver. Segments are labeled 1 to 8. The vertical planes defined by the right hepatic vein (RHV), middle hepatic vein (MHV), and left hepatic vein (LHV) are shown as straight lines. Other key landmarks are identified. Note the difficulty of applying straight geometric planes to curving vessels. This patient has had a cholecystectomy. ARPV, Anterior branch of the RPV; FLT, fissure of the ligamentum teres; FLV, fissure of the ligamentum venosum; GBF, gallbladder fossa; Ht, heart; IVC, inferior vena cava; LPV, left portal vein; MPV, main portal vein; PRPV, posterior branch of the right portal vein; RPV, right portal vein.