Hepatic veins ultrasound anatomy

Hepatic Veins Ultrasound Anatomy

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The hepatic veins are an essential structure in ultrasound anatomy as they provide critical information about the liver's venous drainage and can help diagnose various pathologies, such as cirrhosis, portal hypertension, and hepatic venous obstruction.
Below is an explanation of the ultrasound anatomy of the hepatic veins, including their role, locations, and characteristics during ultrasound imaging:

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The hepatic veins originate from the periphery of the liver, converging into the inferior vena cava (IVC). LHV, left hepatic vein; MHV, middle hepatic vein; RHV, right hepatic vein.
1. Location and Anatomy
The hepatic veins are responsible for draining deoxygenated blood from the liver into the inferior vena cava (IVC). There are typically three main hepatic veins:

• Right Hepatic Vein (RHV)
• Middle Hepatic Vein (MHV)
• Left Hepatic Vein (LHV)

These veins are positioned to drain the liver’s segments as follows:

• Right Hepatic Vein: Drains the right lobe of the liver.
• Middle Hepatic Vein: Drains the central part of the liver, typically between the right and left lobes.
• Left Hepatic Vein: Drains the left lobe of the liver.

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2. Ultrasound Visualization
The hepatic veins are best visualized using transabdominal ultrasound.

• The liver’s inferior surface (especially the right lobe) is where the hepatic veins can be seen entering the inferior vena cava (IVC).
• The hepatic veins typically show a pulsatile flow pattern with bidirectional flow on Doppler ultrasound.

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3. Normal Ultrasound Appearance
Gray-Scale Imaging:

• The hepatic veins appear as anechoic (black) structures on gray-scale imaging.
• They are seen as parallel lines within the liver, usually running perpendicular to the portal vein.

Doppler Imaging:

• Doppler ultrasound provides detailed information about blood flow through the hepatic veins.
• The flow in hepatic veins is typically pulsatile and bidirectional (with systolic and diastolic flow patterns).

Hepatic Vein Diameter by Age (Ultrasound)

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Age Group	Normal Hepatic Vein Diameter
Neonates (0–1 month)	1.5 – 3.5 mm
Infants (1–12 months)	2.0 – 4.5 mm
Children (1–10 years)	3.0 – 6.0 mm
Adolescents (11–18 years)	4.0 – 7.0 mm
Adults (18+ years)	Up to ~8 mm (normal upper limit)

Hepatic Vein Doppler Normal Ranges

Hepatic Vein Doppler Normal Ranges

Parameter	Normal Range	Notes
Hepatic Vein Diameter	≤ 8 mm	May increase in hepatic congestion or disease
Hepatic Vein Velocity (PSV)	15 – 30 cm/s	Monophasic hepatopetal flow
Hepatic Vein Flow Direction	Hepatopetal	Should always flow toward the liver
Hepatic Vein Pulsatility Index (PI)	0.5 – 1.0	Higher values may indicate liver congestion or right heart dysfunction

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Parameter Descriptions

PSV (Peak Systolic Velocity): Highest flow speed during systole.

PI (Pulsatility Index): Measure of the variation in velocity during the cardiac cycle.

Hepatopetal = toward liver; Hepatofugal = away from liver.

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Notes:

Measurements are typically taken at the level of the hepatic hilum and perpendicular to the vessel.

In conditions like portal hypertension or right heart failure, you may see altered Doppler waveforms such as reversed flow or blunted waveforms.

Hepatic veins can show dampened or monophasic flow in hepatic congestion, especially in cirrhosis or Budd-Chiari syndrome.

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Common Hepatic Vein Variations

1. Hepatic Vein Trifurcation: A variation where the main hepatic vein divides into three branches instead of two.

2. Early Branching of Right Hepatic Vein: In some cases, the right hepatic vein branches early before entering the liver.

3. Hepatic Vein Congenital Absence: Rare condition where a hepatic vein may be congenitally absent or malformed.

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Clinical Relevance

Portal Hypertension: Elevated pressure in the portal system can lead to dilated hepatic veins and abnormal Doppler patterns.

Hepatic Vein Thrombosis: Obstruction of the hepatic veins can lead to hepatomegaly, ascites, and hepatocellular damage.

Budd-Chiari Syndrome: Hepatic vein thrombosis can cause liver congestion, leading to severe symptoms.

TIPS Procedure: Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a treatment for portal hypertension that connects the portal vein to the hepatic vein.

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4. Hepatic Veins and Blood Flow
Normal Flow: Hepatic veins carry blood from the liver toward the inferior vena cava. On Doppler, you should see a pulsatile waveform because the venous return is influenced by the cardiac cycle.

• Systolic flow (toward the heart)
• Diastolic flow (away from the heart), especially during ventricular relaxation.

Normal Waveform Characteristics:

• Hepatic veins typically show a regular triphasic waveform, with both systolic and diastolic flow.
• The normal velocity of blood in the hepatic veins is typically between 10 and 30 cm/s.

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5. Pathological Findings in Hepatic Veins
When assessing the hepatic veins in ultrasound, certain pathological conditions can alter the normal appearance of the veins. a) Cirrhosis:

• Cirrhosis can cause liver fibrosis, leading to increased resistance in the hepatic venous outflow.
• This can result in abnormal Doppler flow patterns, such as reversed flow or reduced pulsatility.

b) Portal Hypertension:

• Portal hypertension leads to increased pressure in the portal venous system and can cause hepatic vein dilation and abnormal flow.
• Reversed or dampened flow in the hepatic veins on Doppler may be observed due to the high pressure in the portal circulation.

c) Hepatic Vein Obstruction (Budd-Chiari Syndrome):

• In hepatic vein thrombosis or Budd-Chiari syndrome, there may be complete or partial obstruction of the hepatic veins, leading to reversed blood flow and distended hepatic veins.
• This condition is characterized by the absence of the typical pulsatile flow and can cause hepatomegaly, ascites, and liver congestion.

d) Hepatic Vein Thrombosis:

• Hepatic vein thrombosis results in a loss of the normal pulsatile pattern in the Doppler waveform.
• This can be seen with liver congestion and ascites.

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6. How to Visualize Hepatic Veins on Ultrasound
To visualize the hepatic veins properly:

• Patient Position: The patient should be in a supine position with the right arm extended to allow better access to the liver.
• Probe Selection: Use a curved array probe for optimal imaging, typically 2-5 MHz in frequency.
• Scan Plane: Start with the longitudinal view of the liver and then rotate to a transverse view to visualize the hepatic veins draining into the IVC.
• Doppler Settings: Apply Doppler on the hepatic veins, focusing on the flow pattern in both systole and diastole. You should see a pulsatile wave that is normal in healthy patients.

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7. Hepatic Veins Doppler Imaging in Normal vs. Abnormal Conditions
Normal:

• Clear, pulsatile flow pattern.
• Triphasic waveform.

Abnormal (in pathologies like cirrhosis, portal hypertension, or Budd-Chiari Syndrome):

• Monophasic waveform.
• Absence of diastolic flow.
• Dampened or reversed flow.
• Reduced pulsatility or loss of triphasic waveforms.

Related MCQ

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Hepatic Veins Ultrasound – MCQ Quiz

Note: If you select English, answer all questions in English.
यदि आप हिंदी चुनते हैं, तो सभी प्रश्न हिंदी में हल करें।

1. Which hepatic vein drains the right lobe of the liver? 1. कौन सी हेपेटिक वेन यकृत के दाएं लव को ड्रेन करती है?
A. Right Hepatic Vein / दाएं हेपेटिक वेन
B. Left Hepatic Vein / बाएं हेपेटिक वेन
C. Middle Hepatic Vein / मध्य हेपेटिक वेन
D. Inferior Vena Cava / इन्फीरियर वेना कावा

2. What type of flow is typically seen in the hepatic veins on Doppler ultrasound? 2. डोप्लर अल्ट्रासाउंड पर सामान्य रूप से हेपेटिक वेन में किस प्रकार का प्रवाह देखा जाता है?
A. Monophasic / मोनोफेजिक
B. Biphasic / बाइफेजिक
C. Triphasic / त्रैतीयक
D. Continuous / निरंतर

3. Which of the following is the primary function of the hepatic veins? 3. निम्नलिखित में से कौन सा हेपेटिक वेन्स का प्राथमिक कार्य है?
A. Draining deoxygenated blood from the liver / यकृत से ऑक्सीजन रहित रक्त को बाहर निकालना
B. Transporting oxygenated blood to the liver / यकृत में ऑक्सीजन युक्त रक्त का परिवहन करना
C. Transporting bile to the gallbladder / पित्त को पित्ताशय में परिवहन करना
D. Supplying nutrients to the liver / यकृत को पोषक तत्वों की आपूर्ति करना

4. What pathology might be suggested by a monophasic waveform in the hepatic veins? 4. हेपेटिक वेन्स में मोनोफेजिक वेवफॉर्म से कौन सी पैथोलॉजी का सुझाव मिल सकता है?
A. Hepatic vein thrombosis / हेपेटिक वेन थ्रोम्बोसिस
B. Cirrhosis / सिरोसिस
C. Portal hypertension / पोर्टल उच्च रक्तचाप
D. All of the above / उपरोक्त सभी

5. The hepatic veins are best visualized in which part of the liver? 5. हेपेटिक वेन्स को यकृत के किस हिस्से में सबसे अच्छा देखा जा सकता है?
A. Right lobe / दायां लव
B. Left lobe / बायां लव
C. Caudate lobe / कौडेट लव
D. All of the above / उपरोक्त सभी

6. Which condition is associated with hepatic vein obstruction? 6. कौन सा स्थिति हेपेटिक वेन अवरोध से जुड़ी है?
A. Hepatic vein thrombosis / हेपेटिक वेन थ्रोम्बोसिस
B. Budd-Chiari syndrome / बुद्ध-चियारी सिंड्रोम
C. Cirrhosis / सिरोसिस
D. All of the above / उपरोक्त सभी

7. What is the typical velocity range in hepatic veins on Doppler ultrasound? 7. डोप्लर अल्ट्रासाउंड पर हेपेटिक वेन्स में सामान्य वेग सीमा क्या है?
A. 10 – 30 cm/s / 10 – 30 सेमी/सेकंड
B. 30 – 50 cm/s / 30 – 50 सेमी/सेकंड
C. 50 – 70 cm/s / 50 – 70 सेमी/सेकंड
D. 70 – 90 cm/s / 70 – 90 सेमी/सेकंड

8. Which of the following is an abnormal finding in hepatic veins on ultrasound? 8. अल्ट्रासाउंड पर हेपेटिक वेन्स में निम्नलिखित में से कौन सा असामान्य पाया जाता है?
A. Reversed flow / उल्टा प्रवाह
B. Hepatopetal flow / हेपटोपेटल प्रवाह
C. Triphasic waveform / त्रैतीयक वेवफॉर्म
D. Continuous flow / निरंतर प्रवाह

9. Hepatic vein pulsatility index (PI) values greater than 1 may indicate which condition? 9. हेपेटिक वेन पल्सटिलिटी इंडेक्स (PI) मान 1 से अधिक होने पर किस स्थिति का संकेत हो सकता है?
A. Right heart dysfunction / दायें हृदय का कार्य
B. Hepatic vein thrombosis / हेपेटिक वेन थ्रोम्बोसिस
C. Portal hypertension / पोर्टल उच्च रक्तचाप
D. All of the above / उपरोक्त सभी

10. What is the primary role of the hepatic veins in the body? 10. शरीर में हेपेटिक वेन्स की मुख्य भूमिका क्या है?
A. Draining oxygenated blood from the liver / यकृत से ऑक्सीजनयुक्त रक्त को बाहर निकालना
B. Draining deoxygenated blood from the liver / यकृत से ऑक्सीजन रहित रक्त को बाहर निकालना
C. Transporting bile from liver to gallbladder / यकृत से पित्ताशय तक पित्त का परिवहन करना
D. Supplying nutrients to the liver / यकृत को पोषक तत्वों की आपूर्ति करना

Portal vein ultrasound anatomy variations

Portal Vein System

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The portal vein system (also called the hepatic portal system) is a network of veins that collects blood from the gastrointestinal organs and spleen and delivers it to the liver for processing.
The portal vein system is a venous network that carries nutrient-rich, deoxygenated blood from the gastrointestinal tract, pancreas, spleen, and gallbladder to the liver. It allows the liver to metabolize nutrients, detoxify substances, and filter pathogens before the blood enters systemic circulation.

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Normal Portal Vein Anatomy (on Ultrasound)

Origin: Formed by the confluence of the splenic vein and superior mesenteric vein (SMV) posterior to the neck of the pancreas.

Course: Travels superiorly and to the right, behind the first part of the duodenum and head of the pancreas, into the porta hepatis.

Branches:

• Main Portal Vein (MPV) divides into. (right and Left).
• Right Portal Vein (RPV): Further divides into anterior and posterior branches.
• Left Portal Vein (LPV): Often has a U- or J-shaped curve before branching into medial and lateral segments.

Normal Portal Vein Diameter by Age (Ultrasound)

Age Group	Normal Portal Vein Diameter
Neonates (0–1 month)	2.5 – 4.5 mm
Infants (1–12 months)	3.0 – 5.5 mm
Children (1–10 years)	4.0 – 7.0 mm
Adolescents (11–18 years)	6.0 – 9.0 mm
Adults (18+ years)	Up to ~13 mm (normal upper limit)
With deep inspiration	May transiently reach ~16 mm

Portal Vein Doppler Normal Ranges

Parameter	Normal Range	Notes
Portal Vein Diameter	≤ 13 mm	May transiently increase with inspiration
Portal Vein Velocity (PSV)	20 – 40 cm/s	Steady, monophasic hepatopetal flow
Portal Vein Flow Direction	Hepatopetal	Should always flow toward the liver
Portal Vein Pulsatility Index (PI)	< 0.5	Higher values may indicate right heart dysfunction or portal hypertension
Portal Vein Resistive Index (RI)	N/A	RI not typically measured in PV; applies more to hepatic arteries

Parameter Descriptions

PSV (Peak Systolic Velocity): Highest flow speed during systole.

RI (Resistive Index):

PI (Pulsatility Index):

Hepatopetal = toward liver; Hepatofugal = away from liver.

Notes:

Measurements are typically taken at the porta hepatis, perpendicular to the vessel.

In portal hypertension, diameter may exceed 13–16 mm in adults.

Portal vein diameter can be affected by hydration, respiration, and body habitus.

Common Portal Vein Variations

1.Trifurcation Pattern (10–15%)

• MPV divides into RPV anterior, RPV posterior, and LPV simultaneously.
• No true right portal vein trunk.
• Can be a pitfall in planning liver surgery or transplantation.

2. Early Branching of RPV (5–10%)

• RPV divides before reaching the hepatic parenchym
• Important in preoperative planning.

3. Quadrifurcation

• Rare; MPV gives rise to four primary branches.
• May complicate segmental anatomy interpretation.

4. Right Posterior Portal Vein Arising Directly from MPV

• Instead of forming a common RPV trunk, the posterior branch comes off MPV directly.

5. Cavernous Transformation

• Not a congenital variant, but a collateral venous network forming due to chronic portal vein thrombosis.
• Appears as multiple tortuous vessels in the porta hepatis region.

Ultrasound Appearance & Considerations

The portal venous system can be recognised on ultrasound as a tubular structure with echogenic walls that enters the liver together with the hepatic artery (HA) at the level of the hepatic hilum (a), and reaches the more distal liver segments. (b) Posterior branch of the right portal vein (RPV); (c) left portal vein (LPV) branches. (c) The caudate lobe can be clearly visualised in this scanning plane (asterisk) between the inferior vena cava (IVC), the ligamentum venosum (LV), and LPV. CBD, common bile duct; EHPV, extrahepatic portal vein.

Clinical Relevance of Variations

Portal Hypertension: Elevated pressure in the portal system, often due to cirrhosis.

Portal Vein Thrombosis: Obstruction of blood flow due to clot.

TIPS Procedure: A shunt between the portal and hepatic vein to reduce portal pressure.

Topic related exam

Portal Vein Ultrasound – MCQ Quiz

Note: If you select English, answer all questions in English.
यदि आप हिंदी चुनते हैं, तो सभी प्रश्न हिंदी में हल करें।

1. Which two veins form the portal vein? 1. पोर्टल वेन किन दो वेनों के मिलने से बनती है?

A. Superior mesenteric and splenic veins / सुपीरियर मेसेंटेरिक और स्प्लेनिक वेन
B. Inferior vena cava / इन्फीरियर वेना कावा
C. Renal vein / रीनल वेन
D. Hepatic artery / हेपेटिक आर्टरी

2. What is the echogenicity of the portal vein wall on ultrasound? 2. अल्ट्रासाउंड पर पोर्टल वेन की दीवार कैसी दिखती है?

A. Echogenic / ईकोजेनिक
B. Hypoechoic / हाइपओइकोइक
C. Isoechoic / आइसोइकोइक
D. Anechoic / एनीकोइक

3. What is the normal flow direction in portal vein? 3. पोर्टल वेन में सामान्य रक्त प्रवाह किस दिशा में होता है?

A. Circular / वृत्ताकार
B. Hepatofugal / हेपटोफ्युगल
C. Reversed / उल्टा
D. Hepatopetal / हेपटोपेटल

4. Which part of the liver does the portal vein supply blood to? 4. पोर्टल वेन लिवर के किस हिस्से को रक्त आपूर्ति करती है?

A. Left lobe / बाएं लोब
B. Right lobe / दाएं लोब
C. Both lobes / दोनों लोब
D. Caudate lobe / काउडेट लोब

5. What is the size of the normal portal vein in adults? 5. वयस्कों में सामान्य पोर्टल वेन का आकार कितना होता है?

A. 8-10 mm
B. 10-12 mm
C. 12-14 mm
D. 14-16 mm

6. What condition can cause portal hypertension? 6. पोर्टल हाइपरटेंशन कौन सी स्थिति में हो सकता है?

A. Cirrhosis
B. Hepatitis
C. Liver cancer
D. All of the above

7. Which of the following is not a cause of portal vein thrombosis? 7. निम्नलिखित में से कौन पोर्टल वेन थ्रॉम्बोसिस का कारण नहीं है?

A. Liver cirrhosis
B. Splenomegaly
C. Bacterial infections
D. Pregnancy

8. How is portal vein thrombosis diagnosed? 8. पोर्टल वेन थ्रॉम्बोसिस का निदान कैसे किया जाता है?

A. CT scan
B. Ultrasound
C. MRI
D. All of the above

9. What is the main role of the portal vein? 9. पोर्टल वेन की मुख्य भूमिका क्या है?

A. Carries blood from the liver to the heart
B. Carries nutrient-rich blood to the liver
C. Carries oxygenated blood to the liver
D. Carries waste products from the liver

10. Which ultrasound finding is typical of portal vein thrombosis? 10. पोर्टल वेन थ्रॉम्बोसिस का सामान्य अल्ट्रासाउंड लक्षण क्या है?

A. Hyperechoic thrombus
B. Anechoic thrombus
C. Normal appearance
D. None of the above

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Hepatic artery Doppler anatomy ultrasound

Hepatic artery Doppler anatomy ultrasound

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Doppler ultrasound of the hepatic artery is a crucial component of hepatobiliary imaging, especially in liver transplant evaluation, liver tumors, or portal hypertension. Here's a guide to the anatomy, technique, and Doppler interpretation:

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Anatomy of the Hepatic Artery (HA) on Ultrasound
1. Origin and Course

The common hepatic artery (CHA) arises from the celiac trunk.

It gives rise to:

• Gastroduodenal artery (GDA)
• Proper hepatic artery (PHA) → divides into right and left hepatic arteries.

The right hepatic artery (RHA) often runs posterior to the common bile duct and anterior to the portal vein (in the portal triad).

2. Portal Triad on Ultrasound

Portal vein: Largest and most posterior (echogenic walls)

Hepatic artery: Small and pulsatile (anterior and medial)

Common bile duct (CBD): Thin-walled and anechoic (anterior and lateral)

Doppler Ultrasound Technique
Preparation

Patient fasting 6–8 hours for better visualization.

Use a curved array transducer (3–5 MHz) or high-frequency linear probe (for transplant or detailed studies).

Scanning Approach

Begin at the porta hepatis, identify the portal vein, then locate the hepatic artery.

Use color Doppler to confirm pulsatile arterial flow.

Apply spectral Doppler to evaluate flow velocity and waveform.

Parameter	Normal Value / Characteristic
Waveform	Low-resistance monophasic
Systolic Peak Velocity (PSV)	~30–100 cm/s
Diastolic Flow	Continuous, forward
Resistive Index (RI)	0.55–0.80

Clinical Applications
Liver Transplant Evaluation

Assess patency of the hepatic artery.

Detect hepatic artery thrombosis, stenosis, or pseudoaneurysm.

Portal Hypertension: Evaluate for arterioportal shunting or altered flow.

Liver Tumors:Tumor vascularity, arterialization of lesions (e.g., HCC).

Tips for Better Imaging

Use power Doppler for slow/low-volume flow.

Adjust PRF and gain for optimal waveform clarity.

Apply angle correction (< 60°) for accurate velocity measurement.

Hepatic Artery Doppler Anatomy Ultrasound – MCQ Quiz

Note: If you select English, answer all questions in English.
यदि आप हिंदी चुनते हैं, तो सभी प्रश्न हिंदी में हल करें।

1. What is the normal Doppler waveform of the hepatic artery? 1. हेपेटिक आर्टरी की सामान्य डॉपलर वेवफॉर्म क्या है?
A. Continuous with low resistance / निरंतर और कम प्रतिरोध
B. Pulsatile with high resistance / पल्सटाइल और उच्च प्रतिरोध
C. Absence of flow / प्रवाह का अभाव
D. No specific pattern / कोई विशिष्ट पैटर्न नहीं

2. Which of the following is a normal feature of the hepatic artery in Doppler ultrasound? 2. डॉपलर अल्ट्रासाउंड में हेपेटिक आर्टरी की निम्नलिखित में से कौन सी सामान्य विशेषता है?
A. Continuous flow with a sharp upstroke / तेज़ उत्थान के साथ निरंतर प्रवाह
B. High resistance with no flow / उच्च प्रतिरोध और प्रवाह का अभाव
C. Monophasic waveform / मोनोफेजिक वेवफॉर्म
D. Pulsatile with low resistance / पल्सटाइल और कम प्रतिरोध

3. What does a high-resistance waveform in the hepatic artery suggest? 3. हेपेटिक आर्टरी में उच्च प्रतिरोध वाली वेवफॉर्म क्या संकेत देती है?
A. Normal hepatic blood flow / सामान्य हेपेटिक रक्त प्रवाह
B. Cirrhosis or portal hypertension / सिरोसिस या पोर्टल हाइपरटेंशन
C. Hepatic artery stenosis / हेपेटिक आर्टरी संकुचन
D. Hepatic tumor / हेपेटिक ट्यूमर

4. What is the significance of a monophasic waveform in the hepatic artery? 4. हेपेटिक आर्टरी में मोनोफेजिक वेवफॉर्म का क्या महत्व है?
A. Normal finding / सामान्य finding
B. Sign of hepatic arterial disease / हेपेटिक आर्टरी रोग का संकेत
C. Indicates portal hypertension / पोर्टल हाइपरटेंशन का संकेत
D. Occurs only in children / केवल बच्चों में होता है

5. How does the hepatic artery waveform change in cirrhosis? 5. सिरोसिस में हेपेटिक आर्टरी की वेवफॉर्म में क्या बदलाव आता है?
A. High-resistance waveform / उच्च प्रतिरोध वाली वेवफॉर्म
B. Low-resistance waveform / कम प्रतिरोध वाली वेवफॉर्म
C. Biphasic waveform / बाइफेजिक वेवफॉर्म
D. No waveform change / कोई वेवफॉर्म बदलाव नहीं

6. What is the typical appearance of the hepatic artery in Doppler ultrasound during systole? 6. डॉपलर अल्ट्रासाउंड में सिस्टोल के दौरान हेपेटिक आर्टरी की सामान्य उपस्थिति क्या होती है?
A. Continuous flow / निरंतर प्रवाह
B. Sharp upstroke / तेज़ उत्थान
C. No flow / कोई प्रवाह नहीं
D. Reverse flow / विपरीत प्रवाह

7. In which condition would you expect a dampened or low-amplitude hepatic artery waveform? 7. किस स्थिति में आप हेपेटिक आर्टरी की ध्वनित या कम आयाम वाली वेवफॉर्म की उम्मीद करेंगे?
A. Portal hypertension / पोर्टल हाइपरटेंशन
B. Normal hepatic function / सामान्य हेपेटिक कार्य
C. Hepatic artery stenosis / हेपेटिक आर्टरी संकुचन
D. Cirrhosis / सिरोसिस

8. Which Doppler feature indicates hepatic artery stenosis? 8. डॉपलर विशेषता क्या हेपेटिक आर्टरी संकुचन को संकेत करती है?
A. Continuous flow / निरंतर प्रवाह
B. Rapid upstroke and reversal / तीव्र उत्थान और पलटाव
C. Increased peak systolic velocity / पीक सिस्टोलिक वेग में वृद्धि
D. No waveform change / कोई वेवफॉर्म बदलाव नहीं

9. What does a pulsatile hepatic artery waveform typically indicate? 9. पल्सटाइल हेपेटिक आर्टरी वेवफॉर्म सामान्यतः क्या संकेत करता है?
A. Cirrhosis / सिरोसिस
B. Portal vein thrombosis / पोर्टल वेन थ्रॉम्बोसिस
C. Normal liver function / सामान्य यकृत कार्य
D. Hepatic artery occlusion / हेपेटिक आर्टरी अवरोध

10. What is the role of Doppler ultrasound in evaluating the hepatic artery? 10. हेपेटिक आर्टरी का मूल्यांकन करने में डॉपलर अल्ट्रासाउंड की क्या भूमिका है?
A. To measure the blood flow rate / रक्त प्रवाह दर मापने के लिए
B. To assess resistance and pulsatility / प्रतिरोध और पल्सटाइलिटी का मूल्यांकन करने के लिए
C. To detect tumors / ट्यूमर का पता लगाने के लिए
D. To examine liver size / यकृत का आकार जाँचने के लिए