URYSM ANATOMIC CLASSIFICATION SYSTEM VARIANTS OF IVC ANATOMY AND CONGENITAL
CURS IN SUPRAHEPATIC IVC W/O VENOUS OBSTRUCTION ABNORMALITIES
SOCIATED WITH INTERUPTION OF THE IVC ABOVE OR BELOW THE HEPATIC VEINS DUPLICATION – MOST COMMONLY OCCURS BELOW THE LEVEL OF THE
CCURS IN THE INFRARENAL IVC W/O ASSOCIATED VENOUS ANOMALY RENAL VEINS. IN MOST CASES, EACH ILIAC VEIN EXTENDS SEPARATELY INTO
EFT SIDED IVC WITH AN ANEURYSM @ THE CONFLUENCE OF THE LEFT INTERNAL AND EXTERNAL ILIAC VEINS THE ABDOMEN. THE LEFT IVC JOINS THE LEFT RENAL VEIN AND THEN
LEAD TO THROMBUS FORMATION AND INCREASED RISK OF EMBOLISM CROSSES MIDLINE TO JOIN THE RIGHT IVC BEFORE ENTERING THE RIGHT
ATRIUM
HEPATIC VEINS TRANSPOSITION – IVC ON THE LEFT SIDE/ AND AORTA ON THE RIGHT SIDE.
ANATOMY CAN BE ASSOCIATED WITH SITUS INVERSUS
INTERUPTION - THE INTRAHEPATIC SEGMENT OF THE IVD DOES NOT
INDICATIONS TO SCAN HEPATIC DEVELOP.
TRUNK BEFORE EXITING THE LIVER AND ENTERING THE IVC SONOGRAPHIC APPEARANCE OF BUDD-CHIARI
VEINS THE AZYGOS AND HEMIAZYGOS VEIN DRAINS THE FLOW FROM THE PELVIS
CHF (CAN CAUSE INCREASEDANDRESISTANCE SYNDROME
LOWER EXTR’S INTO THE SVC / HEPATIC VEINS DRAIN DIRECTLY INTO
TO ECHOGENIC MATERIAL W/INATRIUM
THE RIGHT VEINS
FLOW ENTERING THE RIGHT ATRIUM) HEPATOMEGALY (ACUTE)
VENOUS DRAINAGE SYSTEM ALLOWS THIS LOBE TO BE SPARED FROM SIGNIFICANT TRICUSPID REGURG (CAN CAUDATE LOBE HYPERTROPHY (ACUTE)
COMPLICATIONS CAUSE MARKED ASCITES (ACUTE)
CAUSED BY HEPATIC VENOUS OUTFLOW OBSTRUCTION INCREASED PULSATILITY AND SYSTOLIC HEPATIC VEINS HARD TO SEE DUE TO
FLOW REVERSAL IN THE HEPATIC VEINS) SIGNIFICANT FLUID ACCUMULATION (ACUTE)
THROMBOSIS RIGHT LOBE ATROPHY AND FIBROSIS (CHRONIC)
LIVER TUMOR/MASS EFFECT SPLENOMEGALY (CHRONIC)
DOPPLER OF THE HEPATIC HV THICK WALLED & DIFFICULT TO SEE (CHRONIC)
HEPATIC CONGESTION
VEINS BUDD-CHIARI
BUDD CHIARI SYNDROME SYNDROME LACK OF FLOW IN HV’S
OBSTRUCTION OF HV BY
LIVER DISEASE PORTAL HTN, SLOW PV FLOW AND/OR REDUCED PV FLOW
THROMBUS (#1) STENOSIS, DOPPLER OF RENAL VEINS
MEMBRANE COMPRESSION, OR USE 3-4MM DOPPLER SAMPLE SIZE
TUMOR. @ THE ORIGIN FLOW IS MILDLY PULSATILE
CAUSES INCLUDE: W/ MINIMAL RESPIRATORY PHASICITY
OCP (ORAL CONTRACEPTIVES) NEAR RENAL HILUM CONTINUOUS FLOW
THE DOPPLER TRACING WILL DEMONSTRATE 2 LARGE ANTEGRADE DIASTOLIC HEPATOCELLULAR CA (CARCINOMA) W/MINIMAL RESPIRATORY PHASICITY
AND SYSTOLIC RCC OR ADRENAL CA. CHF CAN CAUSE BILATERAL INCREASED
WAVES FOLLOWED BY A SMALL RETROGRADE COMPONENT THAT PULSATILITY
SYMPTOMS INCLUDE:
CORRESPONDS WITH THE ATRIAL CONTRACTION. THE RIGHT HEPATIC VEIN UNILATERAL INCREASE IN PULSATILITY RELATED TO
PAIN, JAUNDICE, HEMATEMESIS,
SHOULD BE EVALUATED WITH PW DOPPLER IN ACUTE
ASCITES,
THE SAGITTAL VIEW. WHEN THE RHV IS DOPPLERED IN TRNV, THE COURSE OF U/S EXAM
URINARY TECHNIQUE
OBSTRUCTION ORFOR RENAL
DISTAL RENAL VEINS
VEIN
GONADAL VEINS HEPATOMEGALY, PORTAL HTN
THE
S RHV CAUSES
= SYSTOLIC AN
PHASE/ANTEGRADE FLOW RRV BEST SEEN IN TRNV VIEW ANTERIOR
THROMBOSIS TO
OFF AXIS EVALUATION.
D= DIASTOLIC THE LHV AND THE MHV ARE BEST DRAIN THE BLOOD FROM THE TESTICLES OR OVARIES
HOWEVER, FLOW
PHASE/ANTEGRADE RENAL ARTERY
DOPPLERED FROM THE REVERSAL
TRNV THE RIGHT GONADALVEIN EMPTIES DIRECTLY INTO LRV BEST SEEN IN TRV VIEW ANTERIOR TO THE AO
A= ATRIAL KICK, FLOW
ORIENTATION. NORMAL HEPATIC VEIN FLOW IS CONSIDERED TRIPHASIC THE
. IVC AND POSTERIOR TO THE SMA. USE THE LRA AS A
THE LEFT GONADAL VEIN EMPTIES INTO THE LRV LANDMARK TO
NORMAL HEPATIC VEIN FLOW VARICOCELE FIND THE LRV. IF TUMOR INVASION IS SUSPECTED
LEFT GONADAL VEIN HAS A HIGHER RISK OF LEFT WITHIN THE VEIN, EVALUATE ADJACENT ORGANS
SIDED FOR MASS FORMATION (RCC MOSTG COMMON). IF
VARICOCELE FORMATION DUE TO ANATOMIC COURSE THROMBOSIS IS SUSPECTED, EVALUATE THE
DISTAL END CALLED PAMPINIFORM PLEXUS JUST KIDNEY AND IVC FOR A POTENTIAL CAUSE
OR OUTSIDE TESTICLE RENAL VEIN ANATOMY
THE PAMPINIFORM PLEXUS CAN DILATE CAUSING A DRAINS KIDNEYS, URETERS, AND ADRENALS
VARICOCELE RRV COURSES ANTEROMEDIAL TO THE RRA
VARICOCELES ARE LINKED TO INFERTILITY LRV COURSES BETWEEN THE AO AND SMA
RENAL VEIN VALSALVA MANEUVER USED TO INCREASE LRV IS LONGER THAN THE RRV
THROMBOSIS VARICOCELE INDICATIONS TO SCAN RENAL VEINS
VESSEL SIZE AND DEMONSTRATE REFLUX ON PW RENAL MASS – RCC MOST COMMON TUMOR TO
DOPPLER INVADE THE RENAL VEIN OF THE IPSILATERAL KIDNEY
OVARIAN VEIN COMPRESSION SYNDROME TRANSPLANT – EVALUATE FOR THROMBOSIS
THE OVARIAN VEIN NORMALLY CROSSES NUTCRACKER
ANTERIORSYNDROME – SMA COMPRESSES LRV AGAINST THE AO
TO THE CAN LEAD TO LRV THROMBOSIS AND LRV VASCULAR CONGESTION
URETER AS IT TRAVELS CEPHALAD TO JOIN THE
IVC/LRV
A DILATED OVARIAN VEIN CAN CAUSE NOTCHING,
DILITATION, OR OBSTRUCTION OF THE IPSILATERAL
URETER
MOST COMMONLY RELATED TO VARICOSITIES OF THE
CURS IN SUPRAHEPATIC IVC W/O VENOUS OBSTRUCTION ABNORMALITIES
SOCIATED WITH INTERUPTION OF THE IVC ABOVE OR BELOW THE HEPATIC VEINS DUPLICATION – MOST COMMONLY OCCURS BELOW THE LEVEL OF THE
CCURS IN THE INFRARENAL IVC W/O ASSOCIATED VENOUS ANOMALY RENAL VEINS. IN MOST CASES, EACH ILIAC VEIN EXTENDS SEPARATELY INTO
EFT SIDED IVC WITH AN ANEURYSM @ THE CONFLUENCE OF THE LEFT INTERNAL AND EXTERNAL ILIAC VEINS THE ABDOMEN. THE LEFT IVC JOINS THE LEFT RENAL VEIN AND THEN
LEAD TO THROMBUS FORMATION AND INCREASED RISK OF EMBOLISM CROSSES MIDLINE TO JOIN THE RIGHT IVC BEFORE ENTERING THE RIGHT
ATRIUM
HEPATIC VEINS TRANSPOSITION – IVC ON THE LEFT SIDE/ AND AORTA ON THE RIGHT SIDE.
ANATOMY CAN BE ASSOCIATED WITH SITUS INVERSUS
INTERUPTION - THE INTRAHEPATIC SEGMENT OF THE IVD DOES NOT
INDICATIONS TO SCAN HEPATIC DEVELOP.
TRUNK BEFORE EXITING THE LIVER AND ENTERING THE IVC SONOGRAPHIC APPEARANCE OF BUDD-CHIARI
VEINS THE AZYGOS AND HEMIAZYGOS VEIN DRAINS THE FLOW FROM THE PELVIS
CHF (CAN CAUSE INCREASEDANDRESISTANCE SYNDROME
LOWER EXTR’S INTO THE SVC / HEPATIC VEINS DRAIN DIRECTLY INTO
TO ECHOGENIC MATERIAL W/INATRIUM
THE RIGHT VEINS
FLOW ENTERING THE RIGHT ATRIUM) HEPATOMEGALY (ACUTE)
VENOUS DRAINAGE SYSTEM ALLOWS THIS LOBE TO BE SPARED FROM SIGNIFICANT TRICUSPID REGURG (CAN CAUDATE LOBE HYPERTROPHY (ACUTE)
COMPLICATIONS CAUSE MARKED ASCITES (ACUTE)
CAUSED BY HEPATIC VENOUS OUTFLOW OBSTRUCTION INCREASED PULSATILITY AND SYSTOLIC HEPATIC VEINS HARD TO SEE DUE TO
FLOW REVERSAL IN THE HEPATIC VEINS) SIGNIFICANT FLUID ACCUMULATION (ACUTE)
THROMBOSIS RIGHT LOBE ATROPHY AND FIBROSIS (CHRONIC)
LIVER TUMOR/MASS EFFECT SPLENOMEGALY (CHRONIC)
DOPPLER OF THE HEPATIC HV THICK WALLED & DIFFICULT TO SEE (CHRONIC)
HEPATIC CONGESTION
VEINS BUDD-CHIARI
BUDD CHIARI SYNDROME SYNDROME LACK OF FLOW IN HV’S
OBSTRUCTION OF HV BY
LIVER DISEASE PORTAL HTN, SLOW PV FLOW AND/OR REDUCED PV FLOW
THROMBUS (#1) STENOSIS, DOPPLER OF RENAL VEINS
MEMBRANE COMPRESSION, OR USE 3-4MM DOPPLER SAMPLE SIZE
TUMOR. @ THE ORIGIN FLOW IS MILDLY PULSATILE
CAUSES INCLUDE: W/ MINIMAL RESPIRATORY PHASICITY
OCP (ORAL CONTRACEPTIVES) NEAR RENAL HILUM CONTINUOUS FLOW
THE DOPPLER TRACING WILL DEMONSTRATE 2 LARGE ANTEGRADE DIASTOLIC HEPATOCELLULAR CA (CARCINOMA) W/MINIMAL RESPIRATORY PHASICITY
AND SYSTOLIC RCC OR ADRENAL CA. CHF CAN CAUSE BILATERAL INCREASED
WAVES FOLLOWED BY A SMALL RETROGRADE COMPONENT THAT PULSATILITY
SYMPTOMS INCLUDE:
CORRESPONDS WITH THE ATRIAL CONTRACTION. THE RIGHT HEPATIC VEIN UNILATERAL INCREASE IN PULSATILITY RELATED TO
PAIN, JAUNDICE, HEMATEMESIS,
SHOULD BE EVALUATED WITH PW DOPPLER IN ACUTE
ASCITES,
THE SAGITTAL VIEW. WHEN THE RHV IS DOPPLERED IN TRNV, THE COURSE OF U/S EXAM
URINARY TECHNIQUE
OBSTRUCTION ORFOR RENAL
DISTAL RENAL VEINS
VEIN
GONADAL VEINS HEPATOMEGALY, PORTAL HTN
THE
S RHV CAUSES
= SYSTOLIC AN
PHASE/ANTEGRADE FLOW RRV BEST SEEN IN TRNV VIEW ANTERIOR
THROMBOSIS TO
OFF AXIS EVALUATION.
D= DIASTOLIC THE LHV AND THE MHV ARE BEST DRAIN THE BLOOD FROM THE TESTICLES OR OVARIES
HOWEVER, FLOW
PHASE/ANTEGRADE RENAL ARTERY
DOPPLERED FROM THE REVERSAL
TRNV THE RIGHT GONADALVEIN EMPTIES DIRECTLY INTO LRV BEST SEEN IN TRV VIEW ANTERIOR TO THE AO
A= ATRIAL KICK, FLOW
ORIENTATION. NORMAL HEPATIC VEIN FLOW IS CONSIDERED TRIPHASIC THE
. IVC AND POSTERIOR TO THE SMA. USE THE LRA AS A
THE LEFT GONADAL VEIN EMPTIES INTO THE LRV LANDMARK TO
NORMAL HEPATIC VEIN FLOW VARICOCELE FIND THE LRV. IF TUMOR INVASION IS SUSPECTED
LEFT GONADAL VEIN HAS A HIGHER RISK OF LEFT WITHIN THE VEIN, EVALUATE ADJACENT ORGANS
SIDED FOR MASS FORMATION (RCC MOSTG COMMON). IF
VARICOCELE FORMATION DUE TO ANATOMIC COURSE THROMBOSIS IS SUSPECTED, EVALUATE THE
DISTAL END CALLED PAMPINIFORM PLEXUS JUST KIDNEY AND IVC FOR A POTENTIAL CAUSE
OR OUTSIDE TESTICLE RENAL VEIN ANATOMY
THE PAMPINIFORM PLEXUS CAN DILATE CAUSING A DRAINS KIDNEYS, URETERS, AND ADRENALS
VARICOCELE RRV COURSES ANTEROMEDIAL TO THE RRA
VARICOCELES ARE LINKED TO INFERTILITY LRV COURSES BETWEEN THE AO AND SMA
RENAL VEIN VALSALVA MANEUVER USED TO INCREASE LRV IS LONGER THAN THE RRV
THROMBOSIS VARICOCELE INDICATIONS TO SCAN RENAL VEINS
VESSEL SIZE AND DEMONSTRATE REFLUX ON PW RENAL MASS – RCC MOST COMMON TUMOR TO
DOPPLER INVADE THE RENAL VEIN OF THE IPSILATERAL KIDNEY
OVARIAN VEIN COMPRESSION SYNDROME TRANSPLANT – EVALUATE FOR THROMBOSIS
THE OVARIAN VEIN NORMALLY CROSSES NUTCRACKER
ANTERIORSYNDROME – SMA COMPRESSES LRV AGAINST THE AO
TO THE CAN LEAD TO LRV THROMBOSIS AND LRV VASCULAR CONGESTION
URETER AS IT TRAVELS CEPHALAD TO JOIN THE
IVC/LRV
A DILATED OVARIAN VEIN CAN CAUSE NOTCHING,
DILITATION, OR OBSTRUCTION OF THE IPSILATERAL
URETER
MOST COMMONLY RELATED TO VARICOSITIES OF THE
