Ultrasonography in portal hypertension: a sensitive noninvasive test to demonstrate portal-vascular anatomy

Abstract

The accuracy of ultrasonography (US) in delineating the portal vascular anatomy was assessed clinically by the clinician in 30 cases of portal hypertension due to noncirrhotic portal fibrosis and extra hepatic portal venous obstruction. Ultrasonography detected portal vein block in 19 and in 11 patients it was found to be patent. These ultrasonic diagnoses were confirmed by spleno-portovenography (SPV) in all, except in 2 cases due to technical failure. Ultrasononic assessment of the splenic vein was found to be accurate in 93.3% (28/30) of cases. SPV also had similar accuracy of splenic vein assessment when compared with the surgical findings. In one patient, intraperitoneal haemorrhage was encounted following SPV, necessitating emergency surgery. Thus, US was found to be as accurate as splenoportovenography in the assessment of portal vascular anatomy. The imaging technique is cheap, easy, safe, and can be repeated as often as necessary. It should be the procedure of choice in assessing the anatomy of portal vascular system.