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Impact of the Continuous Infusion of Levovist on Color Doppler Sonography in Portal Hypertension

Peter Schiedermaier1,2, Günter Layer3 and Tilman Sauerbruch1

1 Department of General Internal Medicine, University of Bonn, Sigmund Freud Str. 25, D-53105 Bonn, Germany.
2 Present Address: Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken, Germany.
3 Department of Radiology, University of Bonn, D-53105 Bonn, Germany.



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  		Fig. 1A. —68-year-old man with liver cirrhosis and portal hypertension. Unenhanced color Doppler sonogram of confluence of portal vein in subcostal view.

 


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  		Fig. 1B. —68-year-old man with liver cirrhosis and portal hypertension. Echo-enhanced color Doppler sonogram of confluence of portal vein in same subcostal view without changing transducer position.

 


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  		Fig. 2A. —46-year-old man with transjugular intrahepatic portosystemic shunt (TIPS) presented with acute variceal bleeding. Unenhanced color Doppler sonogram reveals occlusion of TIPS, but perfusion in prehepatic portion of portal vein could not be verified (arrow).

 


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  		Fig. 2B. —46-year-old man with transjugular intrahepatic portosystemic shunt (TIPS) presented with acute variceal bleeding. Echo-enhanced color Doppler sonogram reveals partial thrombosis of portal vein with perfusion remaining (arrow).

 


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  		Fig. 2C. —46-year-old man with transjugular intrahepatic portosystemic shunt (TIPS) presented with acute variceal bleeding. Digital subtraction angiographic portography image confirmed subtotal portal thrombosis (arrow).

 


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  		Fig. 3A. —21-year-old woman presented with surgical splenorenal Cooley shunt. Unenhanced color Doppler sonogram failed to detect Cooley shunt.

 


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  		Fig. 3B. —21-year-old woman presented with surgical splenorenal Cooley shunt. Echo-enhanced color Doppler sonogram shows shunt (closed arrow) and splenic vein (open arrow).

 


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  		Fig. 3C. —21-year-old woman presented with surgical splenorenal Cooley shunt. MR angiogram (maximum intensity projection) confirmed patency of Cooley shunt (closed arrow; splenic vein, open arrow; renal vein, arrowhead).

 

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