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Portal Hypertension
Danielle Richman, MD, MS; Mary Frates, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Portal hypertension: Pressure gradient of 12 mm Hg between main portal vein and inferior vena cava &/or hepatic veins
            • Increased portal pressures cause portal blood flow to divert into portosystemic collaterals, eventually resulting in increased arterial resistance and reversal of flow in portal veins

          IMAGING

          • Ultrasonographic Findings

            • CT Findings

              • Angiographic Findings

                • Imaging Recommendations

                  • Diagnostic Pitfalls

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Etiology

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Benson CB et al: Ultrasound of the hepatoportal circulation. In: AbuRahma AF et al, ed. Noninvasive vascular diagnosis, 4th ed: a practical guide to therapy. Springer, New York, 2017
                                  2. Iranpour P et al: Altered Doppler flow patterns in cirrhosis patients: an overview. Ultrasonography. 35(1):3-12, 2016
                                  3. Lee WK et al: Imaging assessment of congenital and acquired abnormalities of the portal venous system. Radiographics. 31(4):905-26, 2011
                                  4. McNaughton DA et al: Doppler US of the liver made simple. Radiographics. 31(1):161-88, 2011
                                  5. de Franchis R et al: Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 53(4):762-8, 2010
                                  6. Robinson KA et al: Doppler sonography of portal hypertension. Ultrasound Q. 25(1):3-13, 2009
                                  7. Wachsberg RH et al: Hepatofugal flow in the portal venous system: pathophysiology, imaging findings, and diagnostic pitfalls. Radiographics. 22(1):123-40, 2002
                                  8. Haag K et al: Correlation of duplex sonography findings and portal pressure in 375 patients with portal hypertension. AJR Am J Roentgenol. 172(3):631-5, 1999
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Definitions

                                            • Portal hypertension: Pressure gradient of 12 mm Hg between main portal vein and inferior vena cava &/or hepatic veins
                                            • Increased portal pressures cause portal blood flow to divert into portosystemic collaterals, eventually resulting in increased arterial resistance and reversal of flow in portal veins

                                          IMAGING

                                          • Ultrasonographic Findings

                                            • CT Findings

                                              • Angiographic Findings

                                                • Imaging Recommendations

                                                  • Diagnostic Pitfalls

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Etiology

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Benson CB et al: Ultrasound of the hepatoportal circulation. In: AbuRahma AF et al, ed. Noninvasive vascular diagnosis, 4th ed: a practical guide to therapy. Springer, New York, 2017
                                                                  2. Iranpour P et al: Altered Doppler flow patterns in cirrhosis patients: an overview. Ultrasonography. 35(1):3-12, 2016
                                                                  3. Lee WK et al: Imaging assessment of congenital and acquired abnormalities of the portal venous system. Radiographics. 31(4):905-26, 2011
                                                                  4. McNaughton DA et al: Doppler US of the liver made simple. Radiographics. 31(1):161-88, 2011
                                                                  5. de Franchis R et al: Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 53(4):762-8, 2010
                                                                  6. Robinson KA et al: Doppler sonography of portal hypertension. Ultrasound Q. 25(1):3-13, 2009
                                                                  7. Wachsberg RH et al: Hepatofugal flow in the portal venous system: pathophysiology, imaging findings, and diagnostic pitfalls. Radiographics. 22(1):123-40, 2002
                                                                  8. Haag K et al: Correlation of duplex sonography findings and portal pressure in 375 patients with portal hypertension. AJR Am J Roentgenol. 172(3):631-5, 1999