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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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8  The Digestive System Organ Scanning

1.12\ Transversely Scanning the

Upper Part of the Porta Hepatis

Fig. 8.12  Transversely scanning the upper part of the porta hepatis

RHD

RPV

227

LL

LHD

LPV

228

M. Zhang

 

 

1.12.1\ Scanning Method

The patient should be on fast for 8–12 h with a supine position. Probe is placed at the level of the right subcostal transversely, scanning slightly oblique to posterior-superior. The patient can be in full and suspended inspiration to make the liver move down.

1.12.2\ Section Structure

Major structures: the porta hepatis, right portal vein, and left hepatic portal vein as well as the right hepatic duct and the left hepatic duct accompanying. Ancillary areas—the right and left liver lobe, oblique section of the caudate lobe and quadrate lobe, inferior vena cava, umbilical and sagittal segment of left portal vein, and left intrahepatic bile duct.

1.12.3\ Measuring Method and Normal

Measuring the left and right portal vein and hepatic duct. RPV and LPV normal value is 0.8– 1.3 cm; larger than 1.3 cm is abnormal. The right and left hepatic duct inner diameter should be less than 0.3 cm.

1.12.4\ Clinical Application Value

This section can be used to observe porta hepatis structure and anatomical relation, to judge whether there are abnormals in right portal vein and left portal vein as well as right hepatic duct and left hepatic duct such as expansion, narrow or space-occupying lesions.

8  The Digestive System Organ Scanning

229

 

 

1.13\ Transverse-Oblique View of the Left Liver Through

Longitudinal Section of the Left Hepatic Vein on the Subxiphoid

Fig. 8.13  Transverseoblique view of the left liver through longitudinal section of the left hepatic vein on the subxiphoid

LL

LHV

IVC

230

M. Zhang

 

 

1.13.1\ Scanning Method

The patient should be on fast for 8–12 h with a supine position. Subxiphoid scanning toward left posterior-superior should be performed. Probe is horizontal.

1.13.2\ Section Structure

The transverse-oblique section of the medial and lateral segment of the left lobe. Longitudinal view of the left hepatic vein. The segment of the left hepatic vein drains into the inferior vena cava. The transverse view of the inferior vena cava.

1.13.3\ Measuring Method and Normal

Measuring inner diameter of the left hepatic vein generally should be less than 1.0 cm. The left

hepatic vein blood flow can be measured by pulsed Doppler.

1.13.4\ Clinical Application Value

(1) The main left hepatic vein traveling in the left fissure of the liver is a useful landmark for separating the left interior lobe from the left exterior lobe. Its distal segment and larger branches running in the left interlobe fissure are a useful landmark for separating the left exterior-superior segment from the left exterior-inferior segment of the left lobe. (2) To observe whether there are dilation, narrowness, or presence of emboli in the left hepatic vein.

8  The Digestive System Organ Scanning

231

 

 

1.14\ Oblique Scanning of the Right

Liver Through the Porta

Hepatis

Fig. 8.14  Oblique scan of the right liver through the porta hepatis

RL

Gb

RPV

CHD

PV

IVC