[MRI of portal cavernoma with biliary involvement].
OBJECTIVE
To assess the value of MRI in the diagnosis of portal cavernoma with biliary obstruction.


METHODS
and methods: six patients referred for clinical suspicion of biliary obstruction and portal cavernoma were explored with MRI. all patients were explored using a signa 1.5 t GE MR unit, with high gradient field strength and torso phased array coil. Biliary ducts were explored with ss-fse sequences of MR-cholangiopancreatography (MRCP), coronal and oblique coronal 20mm thick slices. Then, coronal T2w with shorter TE eff, MR-angiography and delayed T1w sequences were performed. CT scan and sonographic examinations of the liver were performed in all patients. Two patients were operated on and 2 underwent endoscopic retrograde cholangiography.


RESULTS
Three different types of biliary involvement were found: in 3 cases findings that mimic cholangiocarcinoma spreading along the common bile duct and in 3 other cases multiple smooth extrinsic impressions along the common bile duct; in one patient MRCP demonstrated an irregular narrowing of the common bile duct mimicking chronic cholangitis. In all cases, the bile duct varices appeared of low T2W signal; in three cases, fibrosis was identified on delayed sequences.


CONCLUSIONS
MRCP and MR-angiography can be proposed as a first imaging study in patients with portal cavernoma and cholestasis or bile duct dilatation.
Leclerc
J C
JC
Service de radiologie, Hôpital d'adultes, CHU nancy-brabois, rue du morvan, 54500 vandoeuvre.
Cannard
L
L
Debelle
L
L
Laurent
V
V
Béot
S
S
Régent
D
D
D000328:Adult; D000368:Aged; D002779:Cholestasis / Q000209:etiology; D006392:Hemangioma, Cavernous / Q000150:complications / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D019043:Vascular Neoplasms / Q000150:complications / Q000473:pathology*