Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Hepatic Sonography
(Left) Normal triphasic
waveform shows the middle
hepatic vein. (Right) Spectral
Doppler tracing shows the
normal portal vein. The
normal waveform displays
gently undulating low-velocity
flow.
Diagnoses: Liver
(Left) Spectral Doppler tracing
shows the normal hepatic
artery, which has a lowresistance
waveform, with
continuous antegrade flow in
diastole. The peak systolic
velocity normally ranges from
30-60 cm/sec. (Right) Spectral
Doppler waveform of a
patient following liver
transplantation shows a
characteristic "tardus-parvus"
waveform, indicating
upstream stenosis at the
hepatic arterial anastomosis.
Note the low resistive index of
0.41 .
(Left) The normal pancreas st
is more echogenic than the
normal liver ſt. (Right) The
portal veins in the liver
typically have echogenic walls
. By contrast, the hepatic
veins lack echogenic walls .
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