Altered hepatic hemodynamics caused by temporary occlusion of the right hepatic vein: evaluation with Doppler US in 14 patients

PURPOSE: To evaluate with Doppler ultrasonography (US) the altered hepatic hemodynamics caused by temporary occlusion of the right hepatic vein. MATERIALS AND METHODS: The study group consisted of 14 patients being considered for hepatic arterial infusion or transarterial embolization. In all patients, maximum peak velocity of the blood flow in the right portal vein was measured with Doppler US before and during the occlusion of the right hepatic vein. In 13 patients, color Doppler US was performed to evaluate Doppler signal in the portal venous branch in the occluded area before and during occlusion. Average peak velocity in the right hepatic artery in eight patients was measured by using a transducer-tipped guide wire before and during occlusion. RESULTS: Maximum peak velocity of the right portal vein significantly decreased with occlusion (P <.01). Hepatic venous occlusion changed the Doppler signal in the portal venous branch in the occluded area from hepatopetal to no signal in 10 patients; to weakened hepatopetal in two; and to hepatofugal in one. Average peak velocity of the right hepatic artery showed a decrease or plateau for 15-30 seconds after the start of occlusion and then a rapid increase to reach a plateau at around 75-90 seconds, with 1.5-2 times as much velocity as that before occlusion. CONCLUSION: Increase in hepatic arterial velocity is accompanied by a decrease in the portal velocity with temporary occlusion of the right hepatic vein; the expected increased drainage through the portal vein was almost undetectable.