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Abdominal
Imaging
Springer Science+Business Media, LLC 2007 Published online: 12 August 2007
Abdom Imaging (2008) 33:7279 DOI: 10.1007/s00261-007-9200-x
Portal vein thrombosis: CT features
Hae-Kyung Lee,1 Seong Jin Park,1 Bum-Ha Yi,1 Eun-Kyeong Yeon,1 Jung Hoon Kim,2 Hyun-Sook Hong1
1Department of Radiology, Soonchunhyang University, Bucheon Hospital, 1174 Jung-Dong Wonmi-Gu, Bucheon-Shi Kyungki-Do, South Korea
2Department of Radiology, Soonchunhyang University, Seoul Hospital, Seoul, South Korea
Abstract
There are many causative diseases to produced portal vein thrombosis (PVT) with the most common being liver cirrhosis with hepatocellular carcinoma. Visualization of abnormalities associated with PVT is crucial to diagnosis and appropriate intervention. Dynamic contrast enhanced CT is the best means of diagnosis of PVT and evaluation of various causative diseases. The ndings of PVT of the dynamic CT are lling defect partially or totally occluding the vessel lumen and rim enhancement of the vessel wall. Signs and symptoms of PVT may be subtle or nonspecic and overshadowed by the underlying illness. Radiologists should be aware of the clinical situations that predispose a patient to portal or mesenteric vein thrombosis.
Key words: Portal vein thrombosisCTLiver diseaseNeoplasmInfection
Portal vein thrombosis (PVT) occurs in various clinical settings, with the most common being liver cirrhosis and hepatocelluar carcinoma (HCC). Other processes that may cause portal vein thrombosis are neoplasms, infectious diseases, myeloproliferative disorder, hypercoagulable states, surgery, and embolism from a thrombus located in the superior mesenteric or splenic vein [1, 2]. Signs and symptoms of PVT may be subtle or nonspecific and overshadowed by the underlying illness [3]. And PVT may be recognized only after imaging studies of the abdomen are performed for other reasons. Radiologists should be aware of the clinical situations that predispose a patient to portal vein thrombosis and should also be able to recognize the sequelae of chronic thrombosis. The primary abnormality in PVT is direct visualization of
thrombus within the portal vein lumen (Fig. 1). Thrombus is usually seen as a hypodense-filling defect in the portal vein lumen, with partial or complete occlusion on contrast-enhanced scans, sometimes with extension into splenic or superior mesenteric veins [4]. Unenhanced scans have been shown to be of minimal benefit in the identification of thrombus. Indirect signs of PVT are the presence of cavernous transformation of the portal vein (Fig. 2), portosystemic collateral...