Ultrasonic measurements of portal vasculature in diagnosis of portal hypertension. A controversial subject reviewed.

In a prospective ultrasound study, the various factors possibly influencing the portal vasculature were evaluated in normal subjects; the correlation of portal diameters with physical factors such as age, sex, and body texture was poor, whereas the caliber variation was significant with respiration, posture, and meal. Considering the fasting state, supine decubitus, and deep inspiration as suitable and standard variables, the diameters were compared in 100 healthy subjects and 50 patients with portal hypertension. The upper normal limits of portal, splenic, and superior mesenteric vein diameters were reported as 16, 12, and 11 mm, respectively, and the dimensions above these values provided an overall sensitivity of 72%, an accuracy of 91%, and a specificity of 100% in diagnosing the patients with suspected portal hypertension.