The authors implemented a study in 20 patients where they investigated the possibility and diagnostic contribution of a modern contrast substance for ultrasonography, Levovist R (SH U 508A) in Doppler examinations of the portal circulation. They compared the native and post-contrast examinations of the portal region. The contrast substance was administered into the cubital vein by means of an infusion pump at the rate of 1-2 ml/min. The post-contrast examination was focused in particular on the area of the liver hilus, hepatic veins and the site of portocaval anastomoses. The general effect of administration of the contrast substance was evaluated not only from the aspect of a more intense Doppler signal, but the main criterium was the contribution of post-contrast examination for the assessment of the diagnosis. In the area of the liver hilus and hepatic veins the post-contrast examination did not provide in any patient new diagnostic information, however the imaging of these structures improved strongly in all patients. In 12 patients the native picture of the flow through the v. mesenterica superior was unsatisfactory, in 3 (2%) after administration of the contrast substance the flow in this vein was visualized along the whole course. In 8 patients the native picture did not visualize the lienal vein, in 3 (37.5%) it was visualized along the whole course. Portocaval anastomoses were confirmed by fibroscopy in 16 patients, in 7 (43.7%) of the patients after administration of Levovist the portocaval collaterals which could not be detected on the native picture were visualized. When evaluating the general effect of the contrast substance, in one patient without the use of Levovist the diagnosis could not have been established, in 7 patients the contrast substance provided new diagnostic information and in 12 patients only better images. Conclusion: The contrast substance Levovist is unequivocally an asset in examinations of the portal circulation. In the great majority it improves the image of vascular structures of the portal circulation but its administration, as a rule, does not alter the diagnosis assessed by the native examination.

        Key words: ultrasonography - contrast substances - portal hypertension - portocaval anastomoses