Diagnostic Ultrasound - Abdomen and Pelvis

09.07.2019 Views

Liver Rectus abdominis muscle LEFT LOBE OF LIVER: LEFT PORTAL VEIN Anatomy: Abdomen Left portal vein Middle hepatic vein IVC RIght hepatic vein Rectus abdominis muscle Left portal vein IVC Rectus abdominis Left portal vein Middle hepatic vein Right portal vein Right hepatic vein IVC Left lobe lateral segment Ligamentum venosum Caudate lobe Spectral tracing of left portal vein (Top) Transverse grayscale ultrasound of the left lobe of the liver is shown, centered at the left portal vein. (Middle) Transverse color Doppler ultrasound of the left lobe of the liver is shown, centered at the level of the left portal vein. Flow in the left portal vein is directed towards the transducer, indicating that the flow is hepatopetal and therefore normal. (Bottom) Spectral tracing of the left portal vein on this transverse pulsed Doppler ultrasound shows that the flow is monophasic, directed towards the transducer, with a mildly undulating waveform related to slight transmission of the cardiac cycle, which is a normal appearance for the portal vein. 11

Liver Anatomy: Abdomen LEFT LOBE OF LIVER: LEFT HEPATIC VEIN Left rectus abdominous muscle Right rectus abdominis muscle Middle hepatic vein Right hepatic vein Left hepatic vein Left rectus abdominis muscle Segment 8 Segment 7 Middle hepatic vein Segment 2 Left hepatic vein IVC Left rectus abdominis muscle Middle hepatic vein Right hepatic vein Left hepatic vein A wave D wave S wave (Top) Transverse grayscale ultrasound of the liver centered at the left hepatic lobe shows the right, middle, and left hepatic veins as they join into the intrahepatic IVC. (Middle) Transverse color Doppler ultrasound of the liver, centered at the confluence of the hepatic veins, shows that the flow direction is away from the transducer, directed towards the IVC. (Bottom) Spectral tracing the left hepatic vein near the confluence with the IVC shows a characteristic triphasic waveform pattern, which represents reflection of cardiac motion. 12

Liver<br />

Rectus abdominis muscle<br />

LEFT LOBE OF LIVER: LEFT PORTAL VEIN<br />

Anatomy: <strong>Abdomen</strong><br />

Left portal vein<br />

Middle hepatic vein<br />

IVC<br />

RIght hepatic vein<br />

Rectus abdominis muscle<br />

Left portal vein<br />

IVC<br />

Rectus abdominis<br />

Left portal vein<br />

Middle hepatic vein<br />

Right portal vein<br />

Right hepatic vein<br />

IVC<br />

Left lobe lateral segment<br />

Ligamentum venosum<br />

Caudate lobe<br />

Spectral tracing of left portal vein<br />

(Top) Transverse grayscale ultrasound of the left lobe of the liver is shown, centered at the left portal vein. (Middle) Transverse color<br />

Doppler ultrasound of the left lobe of the liver is shown, centered at the level of the left portal vein. Flow in the left portal vein is<br />

directed towards the transducer, indicating that the flow is hepatopetal <strong>and</strong> therefore normal. (Bottom) Spectral tracing of the left<br />

portal vein on this transverse pulsed Doppler ultrasound shows that the flow is monophasic, directed towards the transducer, with a<br />

mildly undulating waveform related to slight transmission of the cardiac cycle, which is a normal appearance for the portal vein.<br />

11

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