Peripheral portal venous blood flow alterations induced by hepatic masses: Evaluation with color and pulsed Doppler sonography

We examined 29 patients with intra- and extrahepatic masses and 10 normal volunteers with duplex and color Doppler ultrasonography. Portal blood flow adjacent to the masses was categorized as anterograde, retrograde, or nondetectable and was correlated with lesion size, character, and location. Anterograde flow was documented in the main portal vein and in the central right and left portal veins in all patients and volunteers. Flow in the peripheral portal veins near the lesion examined was retrograde in 17, anterograde in 10, and nondetectable in two of the patients. Retrograde peripheral flow was seen only in solid lesions, abscesses, and large subcapsular hematomas. Peripheral portal flow was anterograde in all of the volunteers. This study confirms that color Doppler sonography can detect alterations in portal flow induced by intra- and extrahepatic masses. The relatively common presence of peripheral portal flow reversal. in patients with metastases and hepatocellular carcinomas indicates that it is not a reliable sign for differentiation between these entities.