篠塚 望

Nozomi SHINOZUKA

埼玉医科大学第一外科

The First Department of Surgery, Saitama Medical School

キーワード : 2-D Doppler echography, Tricuspid regurgitation, Hepatic venous flow, Portal venous flow

Using real-time two-dimensional Doppler echography (2DD), the effects of hepatic venous flow on the portal venous flow were assessed. A total of 62 cases were examined. Of those, 25 were normal controls, while the remaining 37 cases suffered from tricuspid regurgitation (TR). The portal and hepatic venous flow velocities were measured at the right anterior portal venous branch and right hepatic vein, respectively. Flow patterns were classified according to both color flow mapping and the pulsed-Doppler spectrum.
In the controls, most of the hepatic venous flow patterns were biphasic, with systolic flow velocity greater than diastolic flow velocity. The portal venous flow was constant in the control patients. Among the controls, the difference between the maximum velocity (V. max) and the minimum velocity (V. min), the pulsatile value, was equal to or less than 8 cm/sec.
In patients with TR, the systolic flow velocity in the hepatic veins decreased, while the pulsatile value of the portal venous flow increased. In cases with severe TR, regurgitation occurred in both the hepatic and portal veins during cardiac systole. The V. max of the reversed hepatic venous flow correlated well with the pulsatile value of the portal venous flow. (r=0.81, p Since the portal venous flow is affected by the hepatic venous flow, it is important to measure both flows in the assessment of liver circulation in cardiac patients.