Porto-sinusoidal vascular disease with portal hypertension versus liver cirrhosis: differences in imaging features on CT and hepatobiliary contrast-enhanced MRI

Contrast‐enhanced CT and liver surface nodularity for the diagnosis of porto‐sinusoidal vascular disorder: A case‐control study

“…[ 17 ] We demonstrate here that LSN also has an excellent interobserver agreement in patients with PSVD. In the present study, contrary to most previous studies, [ 10–14 ] patients with PSVD and cirrhosis were matched on severity of liver disease reflected by ascites. Indeed, ascites is the only feature associated with survival both in patients with PSVD and in patients with cirrhosis.…”

Porto-sinusoidal vascular disorder

“…Liver surface nodularity, which is a typical finding in cirrhosis, is lacking in most cases of PSVD. In a recent CT/MR study, only 16% of patients with proven PSVD exhibited a nodular liver surface 65 (Fig. 4).…”

“…4), while segment IV atrophy is more common in cirrhosis. 21,65,66 Furthermore, marginal atrophy associated with compensatory central hypertrophy has been described, particularly in patients who have had the disease for a long time. 67,68 In addition, signs of portal hypertension (large splenomegaly, porto-systemic collaterals, dilatation of the portal vein, splenic vein and mesenteric vein) are more severe in patients with PSVD compared to patients with cirrhosis and similar liver function (Fig.…”

Identifying Patients at High Risk of Developing Non-Cirrhotic Portal Hypertension

“…[13][14][15] To facilitate the distinction between PSVD and cirrhosis, imaging techniques may be helpful. By comparing the abdominal CT-scans or MRI of cirrhotic and PSVD patients, Kang 16 showed that liver surface nodularity was more typical of patients with cirrhosis than in the PSVD group (89.2%) as well as the caudate lobe hypertrophy and atrophy of segment IV. However, all these radiological characteristics can also be seen in the patients with PSVD, making the distinction difficult in a given individual patient.…”