MR imaging of portal venous thrombosis: correlation with CT and sonography

Zirinsky, K; Markísz, John A.; Rubenstein, W. A.; Cahill, Patrick; Knowles, R.; Auh, Yong Ho; Morrison, Heather; Kazam, Elias

doi:10.2214/ajr.150.2.283

Cited by 74 publications

(30 citation statements)

References 17 publications

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“…Duplex sonography has proved most effective in the evaluation of cavernous transformation of the portal vein and in the follow-up evaluation of patients with SMV and portal vein thrombosis [25,26]. Nevertheless, difficulties can occur, and sonography may fail to provide the correct diagnosis [27,30]. Lack of demonstrable flow does not always indicate thrombosis; therefore, other imaging modalities, particularly CT, should be performed for confirmation [26].…”

Section: Discussionmentioning

confidence: 99%

Computed tomography of superior mesenteric vein thrombosis following appendectomy

et al. 1998

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During a 5-year period, superior mesenteric vein (SMV) thrombosis was detected with computed tomography (CT) in six patients shortly after an appendectomy. No sign of SMV was present at appendectomy, and a period of more than 2 weeks free of clinical symptoms had elapsed between the appendectomy and the onset of the SMV thrombosis. In four cases, the appendicitis was complicated. These patients had nonspecific signs and symptoms, although two of them had elevation of blood hepatic enzyme levels. In all cases, postcontrast CT demonstrated enlargement of the SMV, with well-defined enhancement of the vascular wall and an intraluminal clot. In one case, CT showed extension of the thrombus to the portal vein with the presence of low-attenuation areas in the liver, consistent with hepatic infarcts. Two patients had predisposing diseases: idiopathic hypersplenism in one case and chronic hepatic disease in the other. SMV thrombosis is a possible complication of appendicitis, and early appendectomy in appendicitis can prevent this complication. Moreover, as in any abdominal surgery, early appendectomy may be complicated by thrombosis of the SMV, thus creating problems of postoperative diagnosis. The complication is more frequent when the initial operation is performed under difficult conditions (peritonitis), or when the patient presents with a coagulopathy. CT is useful in the diagnosis of SMV thrombosis, thus leading to early management with anticoagulant therapy, with a view to avoiding complications such as intestinal ischemia, portal vein thrombosis, and hepatic infarction.

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Section: Discussionmentioning

confidence: 99%

Computed tomography of superior mesenteric vein thrombosis following appendectomy

et al. 1998

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“…The real-time sonography, CT, and angiography findings in SVT have been extensively described in the literature [3][4][5]. A few recent reports have focused attention on the value of duplex Doppler sonography [6][7][8] and MRI [9][10][11], which not only study vessel morphology and patency but also flow velocity and direction in addition to thrombus detection. In this study, duplex Doppler sonography was performed in three patients with portal vein thrombosis and cavernous transformation; the Doppler signal from the periportal collateral vascular channels showed hepatopetal lowvelocity flow with absent respiratory variation.…”

Section: Discussionmentioning

confidence: 99%

“…The attenuation values decrease gradually to 33-42 HU from 3-5 weeks [12,13]. Zirinsky et al [11] reported that with MRI recent thrombi (less than 5 weeks old) appeared hyperintense relative to liver and muscle on both T1-and T2-weighted images and that thrombi more than 2 months old may lose their relative hyperintensity on Tl-weighted images. An attempt at estimating the age of thrombi can therefore be made and this has clinical importance as it is assumed that patients with recent thrombi are most likely to benefit from anticoagulant treatment.…”

Section: Discussionmentioning

confidence: 99%

MR, CT, and ultrasonography of splanchnic venous thrombosis

Haddad

Clark

Sharif

et al. 1992

Gastrointest Radiol

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Nine patients with splanchnic venous thrombosis are presented and the value of noninvasive imaging in their initial diagnosis and subsequent follow-up is emphasized. Angiography, traditionally the definitive investigation in such cases, can be reserved for preoperative assessment in those patients considered candidates for surgery. The age of venous thrombi can be estimated by computed tomography (CT) and magnetic resonance imaging (MRI) which aids selection of therapy, and in those anticoagulated, prediction of prognosis.

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“…For the qualitative data, MR imaging is indicated when Doppler studies are inadequate. Magnetic resonance imaging is especially interesting for the detection of portosystemic collaterals [59,60], for the diagnosis of portal vein thrombosis [61,62], and for the diagnosis and evaluation of hepatic venous obstruction. In this last condition, MR imaging is complementary to Doppler sonography and is particularly helpful for the morphologic changes of the liver parenchyma and for the assessment of portal vein and IVC patency [63].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Ultrasound of diffuse liver disease and portal hypertension

Vilgrain

2001

Eur Radiol

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MR imaging of portal venous thrombosis: correlation with CT and sonography

Cited by 74 publications

References 17 publications

Computed tomography of superior mesenteric vein thrombosis following appendectomy

Computed tomography of superior mesenteric vein thrombosis following appendectomy

MR, CT, and ultrasonography of splanchnic venous thrombosis

Ultrasound of diffuse liver disease and portal hypertension

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