Cavernous transformation of the portal vein: three-dimensional dynamic contrast-enhanced MR angiography

Abdom Imaging. 2008 Jul-Aug;33(4):463-8. doi: 10.1007/s00261-007-9292-3.

Abstract

Background: To investigate characteristic features of three-dimensional dynamic contrast-enhanced MR angiography (3D DCE-MRA) and validate its clinical significance for the diagnosis of cavernous transformation of the portal vein (CTPV).

Methods: 3D DCE-MRA, along with subsequent data processing using three-dimensional reconstruction, was performed in 33 CTPV patients. We observed 33 emboli in the portal vein, 29 in the left and/or right portal branches, 18 in the superior mesenteric vein, and nine emboli in the splenic vein.

Results: The main presentation of CTPV on 3D DCE-MRA was the replacement of the normal configuration of the portal vein by numerous distorted hepatopetal collateral vessels, the presence of arterio-portal venous shunts, and the appearance of hepatofugal collateral vessels in the abdominal cavity and wall.

Conclusion: 3D DCE-MRA can be used to simultaneously characterize the portal system and collateral vessels, and can improve the diagnosis and clinical treatment of CTPV.

MeSH terms

  • Collateral Circulation
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Humans
  • Hypertension, Portal / diagnosis*
  • Hypertension, Portal / etiology*
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional*
  • Magnetic Resonance Angiography*
  • Male
  • Portal Vein / pathology*
  • Venous Thrombosis / complications*

Substances

  • Contrast Media
  • Gadolinium DTPA