What is the normal flow pattern of the hepatic veins?

• A. Pulsatile and hepatofugal
• B. Continuous and hepatopetal
• C. Pulsatile and hepatopetal
• D. Continuous and hepatofugal

Answer: (A)

Normal hepatic venous flow is pulsatile and hepatofugal. The hepatic veins drain blood from the liver into the IVC near the right atrium, so the net flow is away from the liver toward the heart. Because these veins sit so close to the heart, their flow is modulated by the cardiac cycle, producing a phasic, pulsatile Doppler signal. This contrasts with the portal venous system, which is hepatopetal and typically continuous and non-pulsatile. Therefore, the normal pattern you should expect is pulsatile flow directed away from the liver (hepatofugal).