Is it possible to recognize portal hypertension with continuous-wave Doppler ultrasonography?

Continuous-wave (CW) Doppler ultrasonography is a well-known technique in the assessment of peripheral and central circulation. The purpose of this study was to find out whether the technique can be used to demonstrate portal hypertension (PH) from liver disease through the evaluation of flow reversal in the veins of the round ligament. One hundred eight patients (50 controls and 58 with PH) underwent abdominal sonography, endoscopic examination, and CW Doppler flowmetry of the umbilical region. In 53 of 58 patients with PH, hepatofugal venous flow was found in the round ligament; this sign was absent in all of the controls. There was remarkable agreement between the results of CW Doppler examination and those of endoscopy and abdominal sonography: its sensitivity was about 91%, and we encountered no false positives. The Doppler ultrasound method is specific for diagnosing PH, simple to perform, and repeatable.