The interpretation of liver Doppler ultrasono¬graphic examinations can be a source of anxiety to those unfamiliar with the basic concepts and terminology, and to those with limited experience in reading these studies.

Every disease process that affects the liver has its own characteristic effect on blood flow pat-terns and, therefore, affects the waveforms in a unique way. This fact forms the basis for using spectral Doppler US in diagnostic radiology.

Mastery of liver Doppler is achieved when one can fluently transition between what is expected (physiologically or pathologically) and what is observed at spectral Doppler Ultrasound.

Pathologic conditions such as portal hypertension, right-sided heart failure, and tricuspid regurgitation have characteristic effects on Doppler waveforms.

Doppler US remains the “workhorse” modality for the evaluation of TIPS patency. Competency in interpreting these examinations requires an understanding of TIPS anatomy and expected flow patterns.