Congenital Extrahepatic Portosystemic Shunts: Spectrum of Findings on Ultrasound, Computed Tomography, and Magnetic Resonance Imaging

Gupta, Pankaj; Sinha, Anindita; Sodhi, Kushaljit Singh; Lal, Anupam; Debi, Uma; Thapa, Babu Ram; Khandelwal, Niranjan

doi:10.1155/2015/181958

Cited by 9 publications

(9 citation statements)

References 17 publications

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“…Extrahepatic portosystemic shunts include congenital vascular malformations, which were first described by Abernethy and Banks (92). Two types have been described based on the presence or absence of the portal vein: in type I, there is absence of intrahepatic portal venous blood flow due to an end-to-side communication between the main portal vein and the IVC (Fig 25), whereas type II is characterized by partial diversion of portomesenteric blood into systemic veins through congenital shunts, which can be portocaval, gastrorenal, mesenterorenal, splenorenal, or mesenteroiliac shunts (93). Acquired extrahepatic portosystemic shunts such as splenorenal shunt and right or left mesenterocaval shunts are often seen in portal hypertension.…”

Section: Portosystemic Venous Shuntsmentioning

confidence: 99%

A Comprehensive Approach to Hepatic Vascular Disease

et al. 2017

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The liver has a complex vascular supply, which involves the inflow of oxygenated blood through the hepatic artery (systemic circulation) and deoxygenated blood through the portal vein (portal circulation), as well as the outflow of deoxygenated blood through the hepatic veins to the inferior vena cava. A spectrum of vascular variants can involve the liver. Some of these variants may result in areas of enhancement that can mimic more serious pathologic conditions. In this article, the authors discuss a spectrum of variants and pathologic conditions that may involve the liver vasculature. These include variants, anomalies, and diseases involving the portal vein, such as rudimentary portal vein, thrombosis, cavernous transformation, thrombotic angiitis, thrombophlebitis, transient hepatic attenuation difference or transient hepatic intensity difference, portal venous aneurysm, and portal vein gas. The hepatic artery can be involved by various diseases, including thrombosis, stenosis, and aneurysm or pseudoaneurysm. Unusual "third inflow" sources of venous inflow are also discussed, including aberrant right gastric vein, aberrant left gastric vein, epigastric-paraumbilical veins, and cholecystic vein. A spectrum of variants and diseases involving the inferior vena cava and hepatic veins, including thrombosis, Budd-Chiari syndrome, veno-occlusive disease, stenosis, torsion, congestive hepatopathy, and peliosis hepatis, are discussed. Vascular shunts are illustrated, including portosystemic shunts (intra- and extrahepatic), arterioportal shunt, shunts of hereditary hemorrhagic telangiectasia, and acquired arteriovenous fistula. Familiarity with the pathogenesis and imaging features of these vascular entities can aid radiologic diagnoses and guide appropriate patient management. RSNA, 2017.

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Section: Portosystemic Venous Shuntsmentioning

confidence: 99%

A Comprehensive Approach to Hepatic Vascular Disease

et al. 2017

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“…Although DSA is the gold standard for angiography examination, it is an invasive examination; and it is not suitable to serve as a routine evaluation method before TIPS. At present, ultrasound, CTA and Magnetic Resonance Angiogram (MRA) have been applied for the preoperative evaluation of TIPS [12,13].…”

Section: Discussionmentioning

confidence: 99%

320-slice CT angiography before hepatic intrahepatic portosystemic shunt for evaluating the puncture approach

Ge¹,

Wang²,

Shao³

et al. 2018

biomedicalresearch

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Objective: This study aims to evaluate the value of 320 slice Computed Tomography Angiography (CTA) in evaluating puncture approaches by simulating Intrahepatic Portosystemic Shunt (IPS) in cirrhotic patients with portal hypertension. Methods: A total of 30 patients with hepatic cirrhosis and portal hypertension, who underwent IPS from November 2014 to January 2017 at Yunnan Province Second People's Hospital, were selected for this study. The CTA data acquired before surgery were retrospectively analysed. The puncture distances and puncture angles from the right hepatic vein, middle hepatic vein and left hepatic vein to the portal vein and its branches were measured and compared with those acquired by Digital Subtraction Angiography (DSA). Then, the differences between the puncture distances and angles acquired by CTA and DSA were evaluated. Results: Differences between puncture distances and angles acquired by CTA and DSA were not statistically significant (P>0.05). Conclusions: Puncture distances and angles acquired by CTA were consistent with those acquired by DSA. This can provide an imaging basis for the preoperative surgical planning of IPS.

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“…26,36,37 Liver nodules, which can be seen in association with extrahepatic shunts, often regress after shunt closure. 36,37,39 Imaging Characteristics…”

Section: Clinical Presentationmentioning

confidence: 99%

Congenital Hepatic Vascular Anomalies

Chewning

2019

Dig Dis Interv

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Congenital hepatic vascular anomalies, following the classification system originally proposed by Mulliken and Glowacki and subsequently developed by the International Society for the Study of Vascular Anomalies, are characterized as either tumors or malformations. The former includes infantile hemangioma, congenital hemangioma, angiosarcoma, and epithelioid hemangioendothelioma. The latter includes arterioportal fistula, portosystemic shunt, arteriovenous malformation, and venous malformation. Despite this well-established system, there still exists confusion in terminology that can lead to delayed diagnosis or improper treatment. Knowledge of the clinical presentation and imaging characteristics of these entities, as well as the nosologic system for vascular anomalies, is essential in arriving at the correct diagnosis, which in turn informs proper treatment.

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Congenital Extrahepatic Portosystemic Shunts: Spectrum of Findings on Ultrasound, Computed Tomography, and Magnetic Resonance Imaging

Cited by 9 publications

References 17 publications

A Comprehensive Approach to Hepatic Vascular Disease

A Comprehensive Approach to Hepatic Vascular Disease

320-slice CT angiography before hepatic intrahepatic portosystemic shunt for evaluating the puncture approach

Congenital Hepatic Vascular Anomalies

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