#POCUS #VExUS answer: Option 4 - can't tell from this image
#Nephpearls #FOAMed
As mentioned by our friends in the thread, the image depicts hepatic artery waveform, not the portal vein. Note aliasing on color flow in the region where Doppler gate is located suggestive of high velocity flow. Anatomically, that area corresponds to that of hepatic artery.
On PW Doppler, the peak velocity is way higher than expected for a portal vein (usually <40 cm/s). Portal vein waveform from the same patient is shown below.
This question is intentionally designed as a trick to underscore a crucial pitfall that every
#VExUS enthusiast should be mindful of.