Diagnostic Ultrasound - Abdomen and Pelvis

Periportal Lesion
Differential Diagnoses: Liver
(Left) Transverse abdominal
US shows an intrahepatic
portosystemic shunt between
the right portal vein and right
hepatic vein ſt, which
appears as an entangled
vascular structure that drains
into the right hepatic vein .
(Right) Transverse abdominal
color Doppler US in a patient
with hepatic cirrhosis shows a
recanalized paraumbilical vein
ſt arising from the left portal
vein and traveling
anteriorly along the falciform
ligament toward the inferior
epigastric vein.
Portosystemic Collaterals
Portosystemic Collaterals
(Left) Transverse color
Doppler US in a patient with
lymphoma involving the liver
shows multiple markedly
hypoechoic masses ſt in a
periportal distribution (right
anterior portal vein ) in the
liver. Lesions are
predominantly hypovascular, a
characteristic imaging
appearance of lymphoma.
(Right) Transverse abdominal
ultrasound shows linear bright
hyperechoic foci ſt caused by
pneumobilia along the
expected course of the biliary
tree.
Diffuse/Infiltrative Hepatic Lymphoma
Pneumobilia
(Left) Longitudinal color
Doppler US shows multiple
echogenic stones ſt within
the common bile duct, causing
upstream biliary ductal
dilation . Color Doppler is
helpful to distinguish
avascular ducts from adjacent
vasculature. (Right)
Transverse abdominal color
Doppler US in a patient with
ovarian cancer shows an illdefined,
hypoechoic
metastasis ſt that infiltrates
the left periportal region,
occluding the left portal vein,
which should normally be
present in this region.
Choledocholithiasis
Metastases
894