Portal biliopathy: imaging manifestations on multidetector computed tomography and magnetic resonance imaging

Aguirre, Diego A.; Farhadi, Farzin A.; Rattansingh, Anand; Jhaveri, Kartik

doi:10.1016/j.clinimag.2011.07.001

Cited by 17 publications

(18 citation statements)

References 13 publications

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“…Stenotic segments are classified as short or long depending on whether they are <25 mm or >25 mm. 8 The wavy appearance of the CBD may be due to the impression of periportal collaterals on the wall of the CBD whereas unusual narrowing is usually due to the fibrotic strictures. Whereas the collaterals enhance during the portal phase, the thickened CBD wall in the region of the fibrotic stricture enhances in the equilibrium phase.…”

Section: Biliary Changesmentioning

confidence: 99%

“…8 Any secondary pathology causing portal vein obstruction like mass lesion or acute pancreatitis can be seen on imaging.…”

Section: Ancillary Findingsmentioning

confidence: 99%

“…CT clearly depicts the cavernous transformation of the portal vein, presence of the intra and extrahepatic portions of the parabiliary and peribiliary plexuses, and gallbladder varices. 8 The extent of thrombosis and patency of portal vein with its extension into splenic vein and superior mesenteric vein and also portal vein branches can be depicted by CT. The exact location of periportal collaterals with exact localization of portosystemic collaterals can be made out.…”

Section: Computed Tomographymentioning

confidence: 99%

“…In a retrospective study of 11 patients on MRI (n = 7) and CT (n = 4), it was found that high resolution CT or MRI were comparable for providing anatomic detail of presence and severity of bile duct dilatation, portal vein obstruction, portal cavernoma and portosystemic collaterals. 8 However all the information about the vascular and biliary findings of PCC on CT comes at the expense of radiation. As the disease may require repetitive imaging, CT is not the preferred technique because of the risks of radiation exposure.…”

Section: Computed Tomographymentioning

confidence: 99%

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Imaging of Portal Cavernoma Cholangiopathy

Kalra

Shankar

Khandelwal

2014

Journal of Clinical and Experimental Hepatology

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Portal cavernoma cholangiopathy (PCC) refers to the biliary changes which occur in the setting of extrahepatic portal vein obstruction and secondary portal cavernoma formation. The main radiological findings include the vascular changes in the form of portosystemic collaterals and biliary changes in the form of extrinsic impressions and strictures. Till date, conventional cholangiography has been the gold standard for the diagnosis of PCC. However, it is an invasive procedure and is associated with complications. At present there is a transition towards non-invasive modalities like ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). The recent advances in these modalities provide an excellent delineation of both the vascular and the biliary changes non-invasively in a short time. The findings of PCC using these newer modalities are not so well described in literature. The findings of PCC also overlap with malignant conditions of biliary tract such as cholangiocarcinoma and compression of biliary tract by malignant adenopathies. In this article we describe the vascular and biliary changes associated with PCC on US, CT and MRI. We also describe the imaging findings using each modality along with their advantages and disadvantages. ( J CLIN EXP HEPATOL 2014;4:S44-S52)

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Section: Biliary Changesmentioning

confidence: 99%

“…8 Any secondary pathology causing portal vein obstruction like mass lesion or acute pancreatitis can be seen on imaging.…”

Section: Ancillary Findingsmentioning

confidence: 99%

Section: Computed Tomographymentioning

confidence: 99%

Section: Computed Tomographymentioning

confidence: 99%

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Imaging of Portal Cavernoma Cholangiopathy

Kalra

Shankar

Khandelwal

2014

Journal of Clinical and Experimental Hepatology

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“…Subsequently due to progressive nature of disease and compromised peripheral portal blood flow, liver parenchymal atrophy with lobulated contours ( Figure 3D) may be seen mimicking imaging features of cirrhosis. Stigmata of cirrhosis like nodular contours, atrophy of medial segments of right lobe, hypertrophy of caudate and lateral segments of left lobe in EHPVO patients have been described by Aguirre et al [21] .…”

Section: Multidetector Computed Tomographymentioning

confidence: 99%

Imaging and radiological interventions in extra-hepatic portal vein obstruction

Pargewar¹,

Desai²,

Rajesh³

et al. 2016

WJR

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Extrahepatic portal vein obstruction (EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension (PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt (PSS) and revision of PSS. Core tip: The present review describes the etiopathogenesis and role of imaging modalities in Extrahepatic portal vein obstruction and role of various radiological interventional procedures in its management. Pargewar SS et al . Imaging and interventions in EHPVOThe advantages and potential limitations of each imaging modality namely endoscopic retrograde cholangiography, ultrasonography and Doppler, multidetector computed tomography, magnetic resonance cholangiography and portovenography, endoscopic ultrasound and ultrasound transient elastography are discussed. Also, the concepts behind the use of interventional procedures like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, splenic artery aneurysmal embolization, balloon occluded retrograde obliteration of portosystemic shunt, etc. , are described.

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Non-tumoral Pathology of the Intrahepatic Biliary Tract

Kovač¹

2020

Imaging of the Liver and Intra-Hepatic Biliary Tract

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Portal biliopathy: imaging manifestations on multidetector computed tomography and magnetic resonance imaging

Cited by 17 publications

References 13 publications

Imaging of Portal Cavernoma Cholangiopathy

Imaging of Portal Cavernoma Cholangiopathy

Imaging and radiological interventions in extra-hepatic portal vein obstruction

Non-tumoral Pathology of the Intrahepatic Biliary Tract

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