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What percentage of blood is supplied to the liver through the portal vein?

75%.

What is the transverse fissure on the visceral surface of the liver between the caudate and quadrate lobes?

Portal hepatis.

Describe the portal veins within the liver.

Thick, bright walls; course within the liver segments.

What landmark identifies the start of the proper hepatic artery from the common hepatic artery?

Gastroduodenal artery.

What is the relationship between the MPV and the IVC?

MPV is anterior to the IVC.

What patient position offers excellent visualization of the porta hepatis?

Right coronal oblique.

Where should the portal vein diameter be measured?

Where it crosses the inferior vena cava.

Which transducer can be useful for assessing the liver surface nodularity?

7 to 9 MHz linear.

What is the normal portal vein diameter with quiet respiration?

13 mm or less.

What type of flow in the portal vein can be caused by severe liver disease?

Helical flow.

What does an increase in caliber of less than 20% in the splenic vein during deep inspiration indicate?

Portal hypertension.

What increases blood flow within the portal, splenic, and SMVs?

Expiration and ingestion of food.

When assessing hepatic vein flow, the S and D waves should show blood flow toward which organ?

Heart.

What is the normal RI in the hepatic artery?

0.5 to 0.7.

What is the most common etiology for portal hypertension in North America?

Cirrhosis.

What is the primary complication of portal hypertension?

Gastrointestinal bleeding.

What is the most common portosystemic collateral shunt in the presence of portal hypertension?

Coronary-gastroesophageal veins.

What are the sonographic findings associated with portal hypertension?

Splenomegaly and hepatofugal flow in the main portal vein.

What type of flow may be seen in the portal vein when an arterioportal fistula is present?

Pulsatile hepatofugal flow.

What is a treatment for portal hypertension that involves jugular vein cannulation?

TIPS.

What are the normal findings in a transjugular portosystemic shunt?

Hepatopetal flow in the portal and splenic veins.

Increased portal vein caliber with no detectable flow suggests what?

Portal vein thrombosis.

What finding helps differentiate between congestive heart failure and portal hypertension?

Increased pulsatility in both the portal and hepatic veins.

What are the sonographic findings in Budd-Chiari syndrome?

Portal hypertension.

What are the clinical features of sinusoidal obstruction syndrome?

Weight loss.

What is true regarding duplex ultrasound assessment of renal vasculature?

Provides anatomic and hemodynamic information, painless and noninvasive.

What is the normal length of the kidney?

10-12 cm.

Kidneys that are joined at the lower poles are called what?

Horseshoe kidneys.

Why is the renal sinus normally brightly echogenic?

Fat and fibrous tissue in the sinus.

What are the triangular-shaped structures that carry urine from the cortex to the renal pelvis?

Renal pyramids.

What is the most common congenital anomaly of the urinary tract?

Duplication of the renal collecting system.

Where does the right renal artery course in relation to the aorta and IVC?

Anterolateral, posterior.

What vessel courses anterior to the aorta but posterior to the SMA?

Left renal vein.

In which part of the renal artery does atherosclerotic disease typically occur?

Origin to proximal third.

What patients might be suspected of having fibromuscular dysplasia in the renal artery?

32 yr old female with poorly controlled hypertension.

What is the most appropriate transducer for evaluating renal arteries?

(Not specified, but often a higher frequency linear transducer is used.)

At which level is a spectral Doppler waveform needed for the renal-aortic ratio?

Proximal, at the level of the celiac and superior mesenteric arteries.

To identify the renal ostia from a midline approach, where is the image obtained from?

(Location not provided in the notes.)

Which ultrasound modality with low-angle dependence helps in identifying duplicate renal arteries?

Power Doppler.

At what angle are flow patterns in kidney parenchyma typically obtained?

0 degrees.

How much difference in renal length suggests compromised flow?

(Specific value not provided in the notes.)

What describes a normal spectral Doppler waveform in the renal artery?

Low-resistance, high-diastolic flow with velocities in the range of 10 to 120 cm/s.

What renal artery duplex findings would be consistent with acute tubular necrosis?

Renal artery velocities of 70 cm/s, EDR of 0.19.

What is measured to determine acceleration time?

Onset of systole to the early systolic peak.

Describe the findings of proximal aortic velocities of 100 cm/s and renal arteries of 200 and 400 cm/s.

Right RAR = 2.0, left RAR = 4.0.

For which renal artery would you expect to see post-stenotic turbulence?

Left renal artery.

What are potential results of misinterpretation of hilar acceleration time?

All of the above (elevated renovascular resistance, systemic arterial stiffness, renal artery stenosis in the 60% to 79% range).

Under what conditions is the renal-to-aortic ratio likely inaccurate?

When abdominal aortic velocities are over 100 cm/s or below 40 cm/s.

What suggests proximal renal vein thrombosis?

Continuous, nonphasic low-velocity flow.

What findings are consistent with increased velocity after renal artery stent placement?

Increased velocity due to size mismatch from the stent to native vessel.

What renal duplex findings indicate high risk for renal atrophy?

Renal artery LAB >400 cm/s and cortical EDV <5 cm/s.

What is the most common vascular complication after renal transplantation?

Renal artery stenosis.