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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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9  Abdominal Vascular Scanning

361

 

 

7\ Inferior Vena Cava

7.1\ Subxyroid Longitudinal View

of the Inferior Vena Cava

 

QL

MIIV

CBD

 

PV

IVC

CL

Fig. 9.26  Subxyphoid longitudinal view of the inferior vena cava

7.1.1\ Scanning Method

The patient should be in a supine position. The probe is placed vertically to subxyphoid, the right of the anterior median line.

7.1.2\ Section Structure

Posthepatic segment of the IVC (long-axis view), longitudinal view of the quadrate and caudate lobes of the liver, hepatic parenchyma near the second porta hepatis.

7.1.3\ Measurement Method and Normal Value

The anterior–posterior diameter is measured at the level of the right atrium opening and posthepatic segment. There is a physiological stenosis near the right atrium.

The diameter changes periodically with respiratory movement (it enlarges during the inspiratory phase and decreases during the expiratory phase).

7.1.4\ Clinical Application Value

Diagnosis of a stenosis, dilation, or occlusion of the IVC. The IVC is a retroperitoneal organ, and lesions around it are of retroperitoneal origin.

362

Z. Xu et al.

 

 

7.2\ Transverse Scanning

of the Inferior Vena Cava on the Subxyphoid View

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GB

 

 

 

 

 

 

 

 

 

 

 

PHA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PV

 

 

 

 

 

 

 

 

 

 

CBD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IVC

 

 

 

 

 

 

 

 

 

 

Ao

 

 

 

 

 

 

 

 

 

 

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Fig. 9.27  Transverse view of the inferior vena cava on the subxyphoid view

7.2.1\ Scanning Method

The patient should be fasted for 8–12 h, and should be in a supine position. The probe is placed transversely at the subxyphoid level, scanning slightly obliquely to the right posterior. The patient should be in full and suspended

inspiration to make the liver move down as an acoustic window for imaging the IVC.

7.2.2\ Section Structure

Transverse view of the IVC posterior to the liver; oblique views of the liver, hepatic veins, and IVC; diaphragmatic top area of the liver near the second porta hepatis.

7.2.3\ Measurement Method and Normal Value

To measure the diameters of the three hepatic veins, the measurements should be done at a distance of 1–2 cm from the IVC. The normal values are: left hepatic vein diameter 0.5–0.9 cm, middle hepatic venous diameter 0.5–0.9 cm, and right hepatic vein diameter 0.4–0.9 cm.

7.2.4\ Clinical Application Value

(1) Observing the area near the second porta hepatis and the area near the diaphragmatic top of the liver. (2) Determining if there is dilation, narrowing, or the presence of emboli in the IVC or hepatic veins. (3) The middle hepatic vein is a boundary between the right hepatic lobe and left hepatic lobe; the left hepatic vein is a boundary mark between the left internal lobe and the left external lobe; the right hepatic vein is a boundary mark between the right anterior lobe and the right posterior lobe.

7.2.5\ Notes

The hepatic veins can enter the IVC directly, or two branches can merge into one, which then enters the IVC.