PERIPHERAL PORTAL VENOUS-BLOOD FLOW ALTERATIONS INDUCED BY HEPATIC MASSES - EVALUATION WITH COLOR AND PULSED DOPPLER SONOGRAPHY

We examined 29 patients with intra- and extrahepatic masses and 10 nor mal volunteers with duplex and color Doppler ultrasonography. Portal b lood flow adjacent to the masses was categorized as anterograde, retro grade, or nondetectable and was correlated with lesion size, character , and location. Anterograde flow was documented in the main portal vei n and in the central right and left portal veins in all patients and v olunteers. Flow in the peripheral portal veins near the lesion examine d was retrograde in 17, anterograde in 10, and nondetectable in two of the patients. Retrograde peripheral flow was seen only in solid lesio ns, abscesses, and large subcapsular hematomas. Peripheral portal flow was anterograde in all of the volunteers. This study confirms that co lor Doppler sonography can detect alterations in portal flow induced b y intra- and extrahepatic masses. The relatively common presence of pe ripheral portal flow reversal. in patients with metastases and hepatoc ellular carcinomas indicates that it is not a reliable sign for differ entiation between these entities.