Thread by @JonahSerranoMD

A straightforward, hands-on approach to Portal Vein Pulsed Wave Doppler.

Physiologic and pathologic waveforms

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#doppler #PWD #echofirst #POCUS #VexUs @ButterflyNetInc

1/ 7 PHYSIOLOGIC

Physiologic flow should be always antegrade and hepatopetal ( towards trasducer). Could be monophasic or gently ondulating,

In doppler it should be red (get the smallest angle posible).

To Remember:

Fugal: Away

Petal: Toward

Normal velocity: 16-40 cms

2/ 7 Hepatic vein ( mainly in atrial contraction ) gets transmitted through the hepatic sinusoids wich causes cardiac variability of portal waveform , and is accentuated in thin subjets.

3/ 7 PATHOLOGY

4/ 7 Increased pulsatility.
Is defined as a pulsatility index > 0.5.

5/ 7 it could be either arterial or venous.

6/ 7 Hepatofugal and slow Flow.

7/ 7 Absent Flow.

Resources:

RT:)

@hepocus @NephroP @TaotePOCUS @POCUSpeek @ABCDEcografia @Sthanu5 @NuvancePOCUS @ASARUC1 @SergioVelM @Radiopaedia @Radiologia_HU