PORTAL-HYPERTENSION - ULTRASOUND SONOGRAPHY, STATE-OF-THE-ART

Splenomegaly, ascites, and anatomy of intra- and extrahepatic portal v essels can reliably be detected by ultrasound in case of portal hypert ension. The increased diameter of the portal vein and its roots is a n ot sufficient sensitive and specific finding in portal hypertension. H owever a marked variation of diameter at the superior mesenteric vein during in- and exspiration is nearly exclusive. With the help of colou r flow imaging or duplex sonography additional finding of blood flow i n the portal system can be detected noninvasively and continuously. Qu antitative bloodflow measurement in routine examinations is unnecessar y and reserved to special questions. Reverse flow or significantly dec reased blood flow relocity or the detection of portocaval collaterals are reliable findings in portal hypertension, In addition thrombosis o f portal vessels and its hemodynamic consequences can be seen, Because underlying diseases e.g. liver cirrhosis or tumours are diagnosed in the same procedure ultrasound techniques are used in first line when p ortal hypertension is suspected, The findings are complementary to end oscopy of upper g.i. tract and lead on the one hand to a well-aimed us e of CT scanning or x-ray splenoportography, and on the other hand - m ake them dispensable in a lot of cases.