CT features of non-malignant portal vein thrombosis: A pictorial review

Qi, Xingshun; Han, Guohong; He, Chuangye; Yin, Zhihua; Guo, Wengang; Niu, Jing; Fan, Daiming

doi:10.1016/j.clinre.2012.05.021

Cited by 28 publications

(25 citation statements)

References 38 publications

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“…Color Doppler ultrasonography (CDUS) and computed tomography were performed to determine the size and location of portal vein thrombus and impairment in portal flow . The degree of thrombosis was classified as partial occlusion and complete occlusion within the main portal vein (MPV) …”

Section: Methodsmentioning

confidence: 99%

“…10,11 The degree of thrombosis was classified as partial occlusion and complete occlusion within the main portal vein (MPV). [10][11][12][13] Refractory ascites was defined as follows: (i) the patient was unresponsive to sodium-restricted diet and intensive diuretic treatment; (ii) the patient was intolerant of diuretic therapy; or (iii) ascites recurred rapidly after therapeutic paracentesis. 14 The response for TIPS treatment was defined as: complete response, the absence of clinically detectable ascites, with or without diuretics and sodium restriction; partial response, the presence of clinically detectable ascites, without the need for further paracentesis; or absent response, the persistence of severe ascites requiring repeated large volume paracentesis.…”

Section: Diagnosis and Definitionsmentioning

confidence: 99%

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Transjugular intrahepatic portosystemic shunt for symptomatic portal hypertension in hepatocellular carcinoma with portal vein tumor thrombosis

Liu

Zhao

et al. 2013

Hepatology Research

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Section: Methodsmentioning

confidence: 99%

Section: Diagnosis and Definitionsmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt for symptomatic portal hypertension in hepatocellular carcinoma with portal vein tumor thrombosis

Liu

Zhao

et al. 2013

Hepatology Research

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“…In our review of the literature, we were unable to find a case of diffuse cholangiocarcinoma presenting in a rapidly fatal fashion with acute portal and mesenteric vein thrombosis. Portal venous thrombosis may be clinically silent and can be found incidentally when abdominal imaging is informed for other reasons 2. Symptoms may be very non-specific, ranging from abdominal pain, dyspepsia, nausea and vomiting to generalised weakness 3.…”

Section: Discussionmentioning

confidence: 99%

Diffuse cholangiocarcinoma presenting with hepatic failure and extensive portal and mesenteric vein thrombosis

et al. 2015

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A 64-year-old previously healthy man presented with a 4-week history of vague right upper quadrant abdominal pain. Imaging studies revealed extensive portal, splenic, superior and inferior mesenteric vein thrombosis with mosaic perfusion and wedge-shaped areas of liver perfusion abnormalities. An extensive thrombophilia workup including tests for factor V Leiden, prothrombin G20210A, lupus anticoagulant, paroxysmal nocturnal haemoglobinuria, protein C and S, homocysteine and antinuclear antibody titres were all negative. Other laboratory testing revealed an elevated alkaline phosphatase (340 IU/L). Surgical exploration and catheter-directed thrombolysis were not felt to be feasible given the extensive clot burden. He was started on anticoagulation therapy. Over the next 10 days, he required intensive care unit admission due to progressive hepatic encephalopathy and fulminant liver failure. He continued to decline and eventually died of multiorgan failure. Autopsy revealed extensive, diffuse intrahepatic cholangiocarcinoma that had almost entirely replaced his normal liver parenchyma.

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“…There are several advantages of this classification. First, it is easy to do the classification because both PVT and portal cavernoma can be clearly identified by CT or MRI imaging [10] , [38] , [39] . Every patient can be clearly classified into a certain type with no ambiguous variable.…”

Section: Discussionmentioning

confidence: 99%

Rational Classification of Portal Vein Thrombosis and Its Clinical Significance

Zhang

Luo

et al. 2014

PLoS ONE

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Portal vein thrombosis (PVT) is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension) and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women) with PVT were examined using contrast-enhanced computed tomography (CT). The percentage of vein occlusion, including portal vein (PV) and superior mesenteric vein (SMV), was measured on CT image. Of 60 patients, 17 (28.3%) met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT) compared to those without SMVT (p<0.001). However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001). Complications of portal hypertension were significantly associated with cirrhosis (p<0.001) rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study.

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CT features of non-malignant portal vein thrombosis: A pictorial review

Cited by 28 publications

References 38 publications

Transjugular intrahepatic portosystemic shunt for symptomatic portal hypertension in hepatocellular carcinoma with portal vein tumor thrombosis

Transjugular intrahepatic portosystemic shunt for symptomatic portal hypertension in hepatocellular carcinoma with portal vein tumor thrombosis

Diffuse cholangiocarcinoma presenting with hepatic failure and extensive portal and mesenteric vein thrombosis

Rational Classification of Portal Vein Thrombosis and Its Clinical Significance

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