Which statement is most consistent with portal hypertension on Doppler findings?

• A. Hepatopedal flow above baseline
• B. Absence of portal venous flow
• C. Increased hepatic arterial resistive index
• D. Portal hypertension

Answer: (D)

Portal hypertension on Doppler is interpreted through the changes it causes in the portal system’s blood flow. When pressure is elevated in the portal circulation, you’d expect flow alterations such as reduced velocity in the portal vein and, in more advanced cases, hepatofugal flow (away from the liver) or dampened, biphasic waveforms, along with potential development of collateral pathways. The option that best fits this scenario is the one that names the condition itself—portal hypertension—as the finding consistent with the Doppler pattern. The other statements describe patterns that would point to different situations: hepatopedal flow toward the liver is more typical of normal portal flow, absence of portal venous flow suggests thrombosis or occlusion, and an increased hepatic arterial resistive index can occur with liver disease but is not the defining Doppler hallmark of portal hypertension.