[MRI in cavernous transformation of the portal vein: secondary biliary abnormalities and portoportal collaterals].
OBJECTIVE
Evaluation of portoportal collateral vessels and associated biliary abnormalities in patients with cavernous transformation of the portal vein by MRI.


METHODS
Review of 34 MRI examinations performed on patients with angiographically or MR-angiographically proven cavernous transformation. The analysis included the pattern of the portoportal collateral circulation and the abnormalities of the biliary system, such as wall thickening, stenosis, dilations and irregularities of the extra-and intrahepatic bile ducts.


RESULTS
23 (67.6%) of 34 patients with cavernous transformation had paracholedochal portoportal collateral vessels, with 22 (64.7%) showing visible luminal channels. Epicholedochal venous collaterals could be observed in 8 (23.5%) patients. 24 (70.5%) of 34 patients demonstrated biliary abnormalities due to portoportal collaterals, leading to stenosis with dilatation of the proximal bile ducts in 8 (23.5%) patients. The ductal walls were irregular in 7 (20.5%) patients, and thickened in 11 (32.3%). The gallbladder wall was thickened in 4 (12.9%) patients.


CONCLUSIONS
Portoportal collaterals in patients with cavernous transformation of the portal vein can be identified by MRI. These collaterals frequently alter the biliary system, which must be considered in differential diagnosis of biliary abnormalities observed in the presence of portoportal collaterals.
Schaible
R
R
Radiologische Klinik, Univrsität Bonn, Germany.
Textor
J
J
Schepke
M
M
Wolff
M
M
Schild
H
H
Kreft
B
B
D000328:Adult; D001649:Bile Duct Diseases / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D001652:Bile Ducts / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004796:Clinical Enzyme Tests; D003097:Collateral Circulation; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000209:etiology; D003251:Constriction, Pathologic; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D011172:Portography; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000150:complications
D003287:Contrast Media; D002097:C-Reactive Protein; D019786:Gadolinium DTPA