Heterogeneous hepatic enhancement on CT angiography in idiopathic portal hypertension

Waguri, Nobuo; Suda, Takafumi; Kamura, Takeshi; Aoyagi, Yoshinobu

doi:10.1046/j.0106-9543.2002.01663.x

Cited by 15 publications

(16 citation statements)

References 13 publications

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“…Liver atrophy is presumably owing to reduced portal venous blood supply to the periphery. 1,2,8,9 Parenchymal loss is not necessarily progressive, and the hepatic functional reserve mostly remains preserved.…”

Section: Transient Elastographymentioning

confidence: 99%

“…10 Although patients with OPV can manifest with a normal, atrophic or even hypertrophic Segment IV. 8,9 Intrahepatic portal venous obliteration leads to impaired hepatic haemodynamics, which, on imaging, manifests as parenchymal perfusion anomalies. This is characterized by heterogeneous portal perfusion with decreased enhancement of the liver periphery.…”

Section: 2mentioning

confidence: 99%

“…[1][2][3] Obliterative portal venopathy (OPV) represents an important cause of NCPH that is characterized by sclerosis and obliteration of the medium-sized portal venous branches leading to portal hypertension. [1][2][3][4][5][6][7][8][9][10] Liver biopsy characteristically shows phlebosclerosis and periportal and perisinusoidal fibrosis amid absent cirrhosis ( Figure 1). [1][2][3] Although, the exact aetiology is contentious, infections and prothrombotic states have been implicated in eastern and western patients, respectively.…”

mentioning

confidence: 99%

“…[1][2][3][8][9][10] Nonetheless, in 20-33% of patients, the liver gradually atrophies and shows functional decompensation, occasionally needing liver transplantation. Although limited literature is available on the radiological manifestations of OPV, recent studies have suggested certain imaging manifestations to be more prevalent in OPV that can allow discrimination from cirrhosis.…”

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confidence: 99%

“…[1][2][3][8][9][10] Also, US Food and Drug Administration has recently issued a warning regarding the potential association of OPV in patients with HIV on didanosine (antiretroviral therapy). 3 OPV primarily affects young patients usually in their third or fourth decades of life.…”

mentioning

confidence: 99%

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Multimodality imaging of obliterative portal venopathy: what every radiologist should know

Arora¹,

Sarin²

2015

BJR

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Obliterative portal venopathy (OPV) is an important cause of non-cirrhotic portal hypertension, which is often erroneously misdiagnosed as cryptogenic cirrhosis. It has a worldwide distribution with majority of cases hailing from the Asian subcontinent. However, recently the disease has gained global attention particularly because of its association with human immunodeficiency virus infection and use of antiretroviral drug therapy (didanosine). As the name suggests, the disorder is characterized by sclerosis and obliteration of the intrahepatic portal vein branches (with attendant periportal fibrosis) leading to portal hypertension amid intriguingly little liver dysfunction. It primarily affects young adults who present with clinically significant portal hypertension in the form of episodes of variceal bleed; however, contrasting liver cirrhosis, the liver function and liver structure remain normal or near normal until late in the disease process. Radiological findings during advanced disease are often indistinguishable from cirrhosis often warranting a liver biopsy. Nevertheless, recent studies have suggested that certain imaging manifestations, if present, can help us to prospectively suggest the possibility of OPV. At imaging, OPV is characterized by a wide range of intrahepatic and/or extrahepatic portal venous abnormalities with attendant changes in liver and splenic volume and stiffness. We shall, through this pictorial review, appraise the literature and illustrate the germane radiological manifestations of OPV that can be seen using different imaging modalities including ultrasonography, CT, MRI, elastography and hepatic haemodynamic studies.

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Section: Transient Elastographymentioning

confidence: 99%

Section: 2mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Multimodality imaging of obliterative portal venopathy: what every radiologist should know

Arora¹,

Sarin²

2015

BJR

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Non-cirrhotic portal hypertension: an imaging review

et al. 2018

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Non-cirrhotic portal hypertension (NCPH) comprises a group of diseases that are characterized by increased portal pressure in the absence of cirrhosis of the liver. It may arise as a result of either primary hepatic disease or the effects of systemic disorders on liver. The natural course of NCPH is largely indolent and benign with an overall better outcome than cirrhosis, as long as the complications of portal hypertension are properly managed and regular surveillance is carried out. However, due to the numerous and variable etiological factors and lack of standardized diagnostic criteria, this entity is under-recognized clinically as well as pathologically and often gets mislabeled as cryptogenic cirrhosis. Therefore, it is imperative for radiologists to be aware of the imaging features of various entities that constitute NCPH to facilitate early recognition of this disorder. The present review shall comprehensively discuss the role of imaging in the diagnosis of obliterative portal venopathy, which is a common and one of the most poorly understood disorders leading to NCPH. The other radiologically relevant entities will also be briefly appraised.

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Can we differentiate HIV-associated obliterative portopathy from liver cirrhosis using MRI?

et al. 2019

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Heterogeneous hepatic enhancement on CT angiography in idiopathic portal hypertension

Abstract: The heterogeneous increase of arterial perfusion in periphery of the liver may be an important feature of idiopathic portal hypertension.

Cited by 15 publications

References 13 publications

Multimodality imaging of obliterative portal venopathy: what every radiologist should know

Multimodality imaging of obliterative portal venopathy: what every radiologist should know

Non-cirrhotic portal hypertension: an imaging review

Can we differentiate HIV-associated obliterative portopathy from liver cirrhosis using MRI?

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