Prevalence of spontaneous hepatofugal portal flow in liver cirrhosis

Gaiani, Stefano; Bolondi, Luigi; Bassi, Silvia; Zironi, Gianni; Siringo, S.; Barbara, L

doi:10.1016/0016-5085(91)90596-d

Cited by 189 publications

(99 citation statements)

References 36 publications

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“…The proposed method is dependent on inflow of portal signal, which, in some cases, can be reversed. This situation was observed only in seven out of 228 patients (3.1%) with liver cirrhosis and portal hypertension (28), and may not constitute a major issue. TI of the T-SLIP placed on the lower abdomen was fixed at 1100 msec, as it was suitable for signal suppression of the venous blood in the IVC and also gave enough time for the suppressed blood signal to flow into the upper abdominal region, where residual signal of the IVC overlaps with the portal vein.…”

Section: Discussionmentioning

confidence: 92%

Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

Shimada

Isoda

Okada

et al. 2009

Magnetic Resonance Imaging

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Purpose:To compare and evaluate images acquired with two different MR angiography (MRA) sequences, three-dimensional (3D) half-Fourier fast spin-echo (FSE) and 3D true steady-state free-precession (SSFP) combined with two time-spatial labeling inversion pulses (T-SLIPs), for selective and non-contrast-enhanced (non-CE) visualization of the portal vein. Materials and Methods:Twenty healthy volunteers were examined using half-Fourier FSE and true SSFP sequences on a 1.5T MRI system with two T-SLIPs, one placed on the liver and thorax, and the other on the lower abdomen. For quantitative analysis, vessel-to-liver contrast (Cv-l) ratios of the main portal vein (MPV), right portal vein (RPV), and left portal vein (LPV) were measured. The quality of visualization was also evaluated. Results:In both pulse sequences, selective visualization of the portal vein was successfully conducted in all 20 volunteers. Quantitative evaluation showed significantly better Cv-l at the RPVs and LPVs in half-Fourier FSE (P Ͻ 0.0001). At the MPV, Cv-l was better in true SSFP, but was not statistically different. Visualization scores were significantly better only at branches of segments four and eight for half-Fourier FSE (P ϭ 0.001 and 0.03, respectively). Conclusion:Both 3D half-Fourier FSE and true SSFP scans with T-SLIPs enabled selective non-CE visualization of the portal vein. Half-Fourier FSE was considered appropriate for intrahepatic portal vein visualization, and true SSFP may be preferable when visualization of the MPV is required.

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Section: Discussionmentioning

confidence: 92%

Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

Shimada

Isoda

Okada

et al. 2009

Magnetic Resonance Imaging

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“…The prevalence of reversed portal flow is variable, from 3.1% to 22% in the literature. 21,22 Discrepancy is likely caused by the different selection of patient populations. Studies that included a high percentage of patients with severe liver failure, 22 as ours, also show high rate of hepatofugal flow.…”

Section: Resultsmentioning

confidence: 99%

“…9,20 In the same way, it has been shown that there is no relationship between the presence of a reversed flow in the portal vein and the presence and size of esophageal varices. 21 The lack of relationship between portal hemodynamic parameters and development of esophageal varices could mean that, unlike some other spontaneous or surgical portosystemic anastomoses, gastroesophageal collaterals are unable to drain an amount of blood sufficient to significantly lower the portal flow.…”

Section: Resultsmentioning

confidence: 99%

Doppler study of mesenteric, hepatic, and portal circulation in alcoholic cirrhosis: Relationship between quantitative doppler measurements and the severity of portal hypertension and hepatic failure

et al. 1998

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“…The prevalence of PVT in compensated liver disease has been reported to be 0.6-16%, 15% (5-26%) in patients awaiting liver transplantation and upto 36% in explanted liver on histopathology. [2][3][4] PVT is seen in upto 35% of cirrhotic patients with hepatocellular carcinoma. 5,6 The lifetime risk of PVT in general population is reported to be 1%.…”

Section: P Ortal Vein Thrombosis (Pvt) Refers To Thrombosismentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

150

147

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Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. ( J CLIN EXP HEPATOL 2015;5:22-40)

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Prevalence of spontaneous hepatofugal portal flow in liver cirrhosis

Cited by 189 publications

References 36 publications

Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

Non‐contrast‐enhanced MR portography with time‐spatial labeling inversion pulses: Comparison of imaging with three‐dimensional half‐fourier fast spin‐echo and true steady‐state free‐precession sequences

Doppler study of mesenteric, hepatic, and portal circulation in alcoholic cirrhosis: Relationship between quantitative doppler measurements and the severity of portal hypertension and hepatic failure

Portal Vein Thrombosis

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