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Vascular Review
Allison Kreft
Created on March 16, 2024
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Transcript
Interactive Slideshow
Hepatic Vasculature Review
Venous System
LT Portal Vein
RT Portal Vein
Main Portal Vein
Splenic Vein
LT Hepatic Vein
RT Hepatic Vein
Middle Hepatic Vein
- drains the spleen, pancreas, and stomach
- courses posterior to the body of the pancreas
- unites with SMV to form the main portal vein
- hepatopetal
- color doppler will depend on transducer and vessel position
Splenic Vein
Hepatopedal
Hepatofugal
- provide 75% of blood flow to the liver
- drains nutrient rich blood from the intestines, spleen, stomach, gallbladder, and pancreas
- transversely oriented and intrasegmental
- formed by the SMV, IMV, and splenic vein
- converge at porta hepatis
- enlarge as they approach the porta hepatis
- surrounded by an echogenic fibrous sheath
- monophasic and unidirectional
Portal Veins
- Longitudinally oriented and intersegmental
- RT, middle, and LT converge into the IVC at the diaphragm to drain blood from the liver
- largest tributaries of the IVC
- enlarge toward the diaphragm
- pulsatile, triphasic, and bidirectional
Hepatic Veins
Hepatic Veins vs. Portal Veins
Splenic Vein
Venous System Normal Waveforms
Portal Venous System
Hepatic Veins
- empties into the right atrium
- changes in size with respiration
- pulsatile at proximal
- phasic, spontaneous at distal
- continuous signal
IVC
Normal Flow
- supply blood to the spleen
- branch of the celiac trunk
- runs superior to the pancreas
- tortuous and typically turbulent
Arterial System
Common Hepatic Artery
- follows the portal vein and CBD
- within the liver it divides into right and left hepatic arteries to supply blood to the liver
- low resistive waveform
- normal RI ranges from 0.5-0.7
- hepatopedal
- branch off the celiac artery
- gives rise to the GDA and turns into proper hepatic artery
Splenic Artery
Proper Hepatic Artery
Variants
Arteries:
- common or right hepatic artery may arise from the SMA
- common or right hepatic artery may arise off the aorta
- left hepatic artery may arise from the left gastric artery
- middle and left hepatic vein may join to form a common trunk before entering the IVC
- a hepatic vein may be absent
- right more commonly absent
- left hepatic frequently duplicated
Hepatic Anomalies
replaced: a vessel arises from an anomalous origin and supplies a portion of the liver solely Two most common variants: replaced right hepatic artery = right hepatic artery arising from the SMA Replaced left hepatic artery = left hepatic artery arising from the left gastric artery
Replaced Hepatic Artery
https://www.wjgnet.com/1007-9327/full/v28/i19/2057.htmhttps://radiopaedia.org/images/4708936?case_id=24894 https://www.swissnephro.org/blog/2016/3/10/liver-doppler-ultrasound-increased-pulsatility-in-portal-vein-flow https://thoracickey.com/ultrasound-of-the-hepatoportal-circulation/ https://radiologykey.com/hepatobiliary-ultrasound/
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With Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like! Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.
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