Cavoportal collateral pathways in vena cava obstruction: imaging features.

Dahan, H.; Arrivé, Lionel; Monnier‐Cholley, Laurence; Hir, Pierre Le; Zins, Marc; Tubiana, Jean-Michel

doi:10.2214/ajr.171.5.9798887

Cited by 40 publications

(39 citation statements)

References 2 publications

(1 reference statement)

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“…The hepatic capsular veins belong to the accessory portal system and communicate with the inferior phrenic vein and the intrahepatic portal system [13]. These veins can play a role as collaterals in superior vena cava (SVC) obstruction [13].…”

Section: Capsular Veinsmentioning

confidence: 99%

“…These veins can play a role as collaterals in superior vena cava (SVC) obstruction [13]. In patients with SVC obstruction, distinct focal contrast enhancement in the liver surface away from the portal area and near the bare area may be seen on early-phase CT scans, especially when contrast medium is injected from upper extremities (Fig.…”

Section: Capsular Veinsmentioning

confidence: 99%

“…Areas of pseudolesions and focal fatty infiltrations in this area can vary with the blood supply from these small The inferior veins of Sappey descend along the falciform ligament and connect with the epigastric veins superiorly and/or inferiorly. Such pathways can become collateral pathways in cases of superior or inferior vena cava obstruction [13,14,15]. Areas of focal contrast enhancement of the liver on early-phase CT may be seen around the falciform ligament (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…5c), especially when contrast medium is injected from the side of vena cava obstruction. These focal enhancements are caused by systemic venous flow through the inferior veins of Sappey [13,14,15]. …”

Section: Introductionmentioning

confidence: 99%

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Small veins entering the liver

et al. 2002

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It is important to recognize and understand focal fatty infiltration and pseudolesions of the liver mimicking liver tumors on CT during arterial portography or helical-CT images. These conditions are caused by venous flow outside the main portal vein. Unless this is borne in mind, incorrect diagnosis and management may follow. This article demonstrates the appearance of the parenchymal changes caused by systemic venous flow and location of the systemic veins entering the liver parenchyma.

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Section: Capsular Veinsmentioning

confidence: 99%

Section: Capsular Veinsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Small veins entering the liver

et al. 2002

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“…There are many reports of blood supply into the liver through small veins outside the portal vein [6][7][8][9][10][11][12]; however, the role of the jejunal veins at the site of biliaryenteric anastomosis (elevated jejunal veins) has not been well investigated. We conducted a retrospective study to evaluate the role played by jejunal veins in hepatopetal flow after such anastomosis and the helical computed tomography (CT) features of hepatopetal flow through the anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Portal flow into the liver through veins at the site of biliary-enteric anastomosis

et al. 2005

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The aim of this study was to establish the role played by jejunal veins in hepatopetal flow after biliary-enteric anastomosis and to evaluate the helical CT features of hepatopetal flow through the anastomosis. We retrospectively analyzed helical CT images of the liver in 31 patients with biliary-enteric anastomosis who underwent hepatic angiography with (n=13) or without (n=18) CT arterial portography within 2 weeks of the CT examination during the last 4 years. Arterial portography showed hepatopetal flow through small vessels located (communicating veins) between the elevated jejunal veins and the intrahepatic portal branches in two (9%) of 22 patients with a normal portal system. Helical CT showed focal parenchymal enhancement around the anastomosis in these two patients. All nine patients with extrahepatic portal vein occlusion (100%) had hepatopetal flow through the anastomosis, and four of the nine had decreased portal flow. CT revealed small communicating veins in two of these four patients. In five patients with normal portal perfusion despite extrahepatic portal vein occlusion, CT detected dilated communicating veins and elevated jejunal veins. The presence of communicating veins and/or focal parenchymal enhancement around the anastomosis indicates hepatopetal flow through the elevated jejunal veins.

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