長沼 裕子, 石田 秀明, 正宗 研

Hiroko NAGANUMA, Hideaki ISHIDA, Osamu MASAMUNE

秋田大学第1内科

First Department of Internal Medicine Akita University School of Medicine

キーワード : Color Doppler Sonography, Hemodynamics, Intrahepatic shunt, Portal vein, Reversal flow

We demonstrate five patterns of reversal portal flow and discuss their clinical significance. Reversal portal flow was observed in 78 out of 1110 (7%) cases, and was roughly classified as (a) pulsatile, (b) continuous, (c) to-and-fro, (d) momentary reversal, or (e) intraluminal rotary. Pulsatile flow was always secondary to arterio-portal venous (A-P) shunt; continuous flow pattern resulted from A-P shunt or collateral circulation; to-and-fro flow was observed in patients with a portal thrombus or hepatic congestion; momentary reversal flow was provoked by decrease in portal venous flow velocity (9.5±4.1 cm/sec, vs 11.6±3.7 cm/sec in normal subjects); and rotary flow was observed in curved or distorted portal veins. Color and pulsed Doppler sonography were very useful for evaluating abnormal portal venous flow.