Liver Doppler

ultrasound protocols for liver doppler study

Liver Doppler

• This is usually performed as an adjunct to an upper abdominal scan
• If indicated Doppler assessment may be performed in isolation
  

Indications

• Requested by referring clinician
• A combination of ultrasound appearances suggestive of portal hypertension, these include (but are not restricted to):
  • Splenomegaly, especially in the absence of another causitive condition
  • Portal vein dilatation (>/= 13mm lumen)
  • Varices, typical of portosystemic collaterals (e.g. para-umbilical, lieno-renal, coronary etc.)
  • Liver surface irregularity consistent with cirrhosis

Assess:

• Splenic vein
• SMV (if possible, often unable to be assessed due to overlying bowel gas)
• Portal vein (main)
• Left and right portal veins
• Ligamentum teres region (for paraumbilical vein varicies)
• Main hepatic artery
• Hepatic veins
• IVC
• Common sites of portosystemic collateral
• Remainder of upper abdomen if indicated
  

Standard Documentation:

• Colour Doppler images / clip store / PW Doppler spectral waveforms +/- clipstore of:
• Splenic vein
• SMV (often unobtainable)
• Main, left and right portal veins
• Hepatic artery
• Main, left and right hepatic veins
• IVC
• Colour Doppler images +/- clipstore of ligamentum teres region, PW Doppler spectral waveforms if para-umbilical collateral is present
• Standard documentation for upper abdomen if indicated
  

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