Why do a Doppler ultrasound study of portal vein?

This female has definitely signs of grade 1 or mild fatty liver. 

In addition there's a gallbladder calculus. 

Have a look:

Compare the echogenicity of the liver and right kidney. Definitely more echogenic than the right kidney. 

Portal vein at 11.5 mm. 

GB calculus 👆

I decided to study the portal vein in detail. Just to be sure. 

Centripetal flow in portal vein. Flow towards the transducer is a good sign. Rules out reverse flow. 

Normal spectral Doppler ultrasound trace.

Final diagnosis: gallbladder calculus with grade 1 fatty liver. Normal flow in portal vein. 

No evidence of portal hypertension. 

More on fatty liver and sonography:

Introduction:

• Fatty liver, also known as hepatic steatosis, is a common liver disease.
• Non-alcoholic fatty liver disease (NAFLD) is a subset or subtype of fatty liver that is not caused by excessive alcohol consumption.
• Patients with NAFLD may have complications such as portal hypertension, which can lead to serious health issues.
• Color and spectral Doppler imaging are non-invasive techniques that can help in evaluating the portal vein in these patients.

Section 1: Fatty Liver and Portal Hypertension

• Fatty liver is associated with increased incidence of portal hypertension.
• Portal hypertension occurs when there is increased pressure in the portal vein that carries blood from the digestive organs to the liver.
• Complications of portal hypertension include varices, ascites, and hepatic encephalopathy.

Section 2: Color Doppler Imaging of the Portal Vein in Fatty Liver

• Color Doppler imaging is a non-invasive technique that uses color to represent blood flow direction and velocity.
• It can help in identifying abnormal flow patterns in the portal vein, such as increased velocity or turbulence.
• This technique can also help in detecting collateral vessels or shunts, which may develop as a result of portal hypertension.

Section 3: Spectral Doppler Imaging of the Portal Vein in Fatty Liver:

• It can provide information on blood flow velocity, volume, and resistance.
• In patients with portal hypertension, spectral Doppler can help in detecting changes in flow characteristics, such as increased velocity and resistance, reversed flow etc. 

Conclusion:

• Color and spectral Doppler imaging are valuable tools in evaluating the portal vein in patients with fatty liver.
• These non-invasive techniques can provide important information on blood flow patterns, velocity, and resistance.
• Early detection of portal hypertension and related complications can help in managing the disease and improving patient outcomes.

For more on liver pathology:

Sonography in liver pathology