Ultrasonic Contrast Portography for Demonstration of Intrahepatic Porto-systemic Shunts

Spontaneous intrahepatic porto-systemic shunts (IHPSS) can be disclosed with ultrasound (US) and color Doppler ultrasound (CDU). However, direct evidence of the shunt on US or CDU may not be convincing. In this report we demonstrate the presence of IHPSS by ultrasonic contrast portography with intravenous injection of microbubble-based contrast agent (MBCA). With this technique, the MBCA was depicted to enter the hepatic vein through the shunt, and then flowed into the inferior vena cava.