Portal vein thrombosis: spectrum of helical CT and CT angiographic findings

Novick, Steven L.; Fishman, Elliot K.

doi:10.1007/s002619900388

Cited by 31 publications

(13 citation statements)

References 7 publications

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“…Most of the postoperative CT scans in our study did not employ a multiphase vascular specifi c technique with a high resolution, thin collimation scan acquiring two portal venous phases with a fast intravenous contrast injection rate. 59,60 Hence, our resolution was not always optimal and the possibility of pre-existing MVT before IPAA could not be ruled out as preoperative CT imaging was not routine among our patient cohort.…”

Section: Discussionmentioning

confidence: 90%

Portal Vein Thrombi After Ileal Pouch-Anal Anastomosis: Its Incidence and Association with Pouchitis

et al. 2007

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Section: Discussionmentioning

confidence: 90%

Portal Vein Thrombi After Ileal Pouch-Anal Anastomosis: Its Incidence and Association with Pouchitis

et al. 2007

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“…Differentiation between tumors and fistulas is particularly important in cirrhotic patients, the population most at risk for HCC, a highly vascularized neoplasm (3). nonenhancing thrombus (3,16,18). When proximal APS occurs in the hepatofugal direction, tumor cells can disseminate into the splanchnic area (15).…”

Section: Hepatic Traumamentioning

confidence: 99%

Improved Diagnosis of Hepatic Perfusion Disorders: Value of Hepatic Arterial Phase Imaging during Helical CT

Quiroga¹,

Sebastiá²,

Pallisa³

et al. 2001

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The liver has a unique dual blood supply, which makes helical computed tomography (CT) a highly suitable technique for hepatic imaging. Helical CT allows single breath-hold scanning without motion artifacts. Because of rapid image acquisition, two-phase (hepatic arterial phase and portal venous phase) evaluation of the hepatic parenchyma is possible, improving tumor detection and tumor characterization in a single CT study. The arterial and portal venous supplies to the liver are not independent systems. There are several communications between the vessels, including transsinusoidal, transvasal, and transplexal routes. When vascular compromise occurs, there are often changes in the volume of blood flow in individual vessels and even in the direction of blood flow. These perfusion disorders can be detected with helical CT and are generally seen as an area of high attenuation on hepatic arterial phase images that returns to normal on portal venous phase images; this finding reflects increased arterial blood flow and arterioportal shunting in most cases. Familiarity with the helical CT appearances of these perfusion disorders will result in more accurate diagnosis. By recognizing these perfusion disorders, false-positive diagnosis (hypervascular tumors) or overestimation of the size of liver tumors (eg, hepatocellular carcinoma) can be avoided.

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“…However, because microvessel invasion is a histopathological diagnosis, it rarely can be evaluated during the preoperative period despite its well-known importance. The role of preoperative imaging studies for assessing vascular invasion remains limited, except in cases where the portal vein tumor thrombus can be grossly visualized [7,8]. To the best of our knowledge, studies that have evaluated the histopathological vessel invasion status of HCC based on preoperative magnetic resonance imaging (MRI) findings are limited [9,10].…”

Section: Introductionmentioning

confidence: 98%

Can microvessel invasion of hepatocellular carcinoma be predicted by pre-operative MRI?

et al. 2009

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Microvessel invasion is a major prognostic factor in hepatocellular carcinoma (HCC) that influences the suitability of surgery, but rarely can be evaluated preoperatively. This study was performed to identify preoperative MRI findings that reflect histopathological microvessel invasion in hepatocellular carcinoma. Gadobenate dimeglumine-enhanced four-arterial phase dynamic study and hepatobiliary phase images of preoperative MRI of 70 HCC lesions were retrospectively reviewed. Tumor size (cm), peritumoral enhancement, tumor margins, and radiological capsule were analyzed as radiological parameters reflecting microvessel invasion and were compared with histopathological references. The chi-square test and the independent t-test were used for univariate analysis, and a logistic regression analysis was performed for multivariate analysis. In univariate analysis, tumor size (p = 0.030), peritumoral enhancement (p < 0.001), and tumor margins (p = 0.007) were associated with microvessel tumor invasion. However, in multivariate analysis irregular circumferential peritumoral enhancement only showed statistical significance (odds ratio 13.0), suggesting a high probability of microvessel invasion of HCC. Irregular circumferential peritumoral enhancement on contrast-enhanced multi-arterial phase dynamic MRI could be a preoperative surrogate marker for microvessel tumor invasion.

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Portal vein thrombosis: spectrum of helical CT and CT angiographic findings

Cited by 31 publications

References 7 publications

Portal Vein Thrombi After Ileal Pouch-Anal Anastomosis: Its Incidence and Association with Pouchitis

Portal Vein Thrombi After Ileal Pouch-Anal Anastomosis: Its Incidence and Association with Pouchitis

Improved Diagnosis of Hepatic Perfusion Disorders: Value of Hepatic Arterial Phase Imaging during Helical CT

Can microvessel invasion of hepatocellular carcinoma be predicted by pre-operative MRI?

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