Hepatofugal flow in the portal venous system: pathophysiology, imaging findings, and diagnostic pitfalls
Hepatofugal flow (ie, flow directed away from the liver) is abnormal in any segment of the portal venous system and is more common than previously believed. Hepatofugal flow can be demonstrated at angiography, Doppler ultrasonography (US), magnetic resonance imaging, and computed tomography (CT). Th...
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| Published in: | Radiographics Vol. 22; no. 1; pp. 123 - 140 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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01-01-2002
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| Abstract | Hepatofugal flow (ie, flow directed away from the liver) is abnormal in any segment of the portal venous system and is more common than previously believed. Hepatofugal flow can be demonstrated at angiography, Doppler ultrasonography (US), magnetic resonance imaging, and computed tomography (CT). The current understanding of hepatofugal flow recognizes the role of the hepatic artery and the complementary phenomena of arterioportal and portosystemic venovenous shunting. Detection of hepatofugal flow is clinically important for diagnosis of portal hypertension, for determination of portosystemic shunt patency and overall prognosis in patients with cirrhosis, as a potential pitfall at invasive arteriography performed to evaluate the patency of the portal vein, and as a contraindication to specialized imaging procedures (ie, transarterial hepatic chemoembolization and CT during arterial portography). Hepatofugal flow is generally diagnosed at Doppler US without much difficulty, but radiologists should beware of pitfalls that can impede correct determination of flow direction in the portal venous system. |
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| AbstractList | Hepatofugal flow (ie, flow directed away from the liver) is abnormal in any segment of the portal venous system and is more common than previously believed. Hepatofugal flow can be demonstrated at angiography, Doppler ultrasonography (US), magnetic resonance imaging, and computed tomography (CT). The current understanding of hepatofugal flow recognizes the role of the hepatic artery and the complementary phenomena of arterioportal and portosystemic venovenous shunting. Detection of hepatofugal flow is clinically important for diagnosis of portal hypertension, for determination of portosystemic shunt patency and overall prognosis in patients with cirrhosis, as a potential pitfall at invasive arteriography performed to evaluate the patency of the portal vein, and as a contraindication to specialized imaging procedures (ie, transarterial hepatic chemoembolization and CT during arterial portography). Hepatofugal flow is generally diagnosed at Doppler US without much difficulty, but radiologists should beware of pitfalls that can impede correct determination of flow direction in the portal venous system. |
| Author | Sofocleous, Constantine T Wachsberg, Ronald H Bahramipour, Philip Barone, Allison |
| Author_xml | – sequence: 1 givenname: Ronald H surname: Wachsberg fullname: Wachsberg, Ronald H email: wachsbrh@umdnj.edu organization: Department of Radiology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA. wachsbrh@umdnj.edu – sequence: 2 givenname: Philip surname: Bahramipour fullname: Bahramipour, Philip – sequence: 3 givenname: Constantine T surname: Sofocleous fullname: Sofocleous, Constantine T – sequence: 4 givenname: Allison surname: Barone fullname: Barone, Allison |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/11796903$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | Arteriovenous Fistula - diagnostic imaging Arteriovenous Fistula - physiopathology Diagnosis, Differential Hepatic Artery - abnormalities Humans Hypertension, Portal - diagnostic imaging Hypertension, Portal - physiopathology Liver Circulation Liver Cirrhosis - diagnostic imaging Liver Cirrhosis - physiopathology Portal Vein - abnormalities Portal Vein - diagnostic imaging Portal Vein - physiopathology Portasystemic Shunt, Surgical Prognosis Ultrasonography, Doppler Vascular Patency |
| Title | Hepatofugal flow in the portal venous system: pathophysiology, imaging findings, and diagnostic pitfalls |
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