Altered hepatic hemodynamics caused by temporary occlusion of the right hepatic vein: Evaluation with Doppler US in 14 patients

PURPOSE: To evaluate with Doppler ultrasonography (US) the altered hepatic hemodynamics caused by temporary occlusion of the right hepatic vein. MATERIALS AND METHODS: The study group consisted of 14 patients being consi dered for hepatic arterial infusion or transarterial embolization. In all p atients, maximum peak velocity of the blood flow in the right portal vein w as measured with Doppler US before and during the occlusion of the right he patic vein. In 13 patients, color Doppler US was performed to evaluate Dopp ler signal in the portal venous branch in the occluded area before and duri ng occlusion. Average peak velocity in the right hepatic artery in eight pa tients was measured by using a transducer-tipped guide wire before and duri ng occlusion. RESULTS: Maximum peak velocity of the right portal vein significantly decre ased with occlusion (P < .01). Hepatic venous occlusion changed the Doppler signal in the portal venous branch in the occluded area from hepatopetal t o no signal in 10 patients; to weakened hepatopetal in two; and to hepatofu gal in one. Average peak velocity of the right hepatic artery showed a decr ease or plateau for 15-30 seconds after the start of occlusion and then a r apid increase to reach a plateau at around 75-90 seconds, with 1.5-2 times as much velocity as that before occlusion. CONCLUSION: Increase in hepatic arterial velocity is accompanied by a decre ase in the portal velocity with temporary occlusion of the right hepatic ve in; the expected increased drainage through the portal vein was almost unde tectable.