Atrophy-hypertrophy complex in patients with cavernous transformation of the portal vein: CT evaluation.
OBJECTIVE
To retrospectively evaluate the morphologic changes in the liver associated with cavernous transformation of the portal vein.


METHODS
This study was institutional review board approved. Informed patient consent was not required. The computed tomographic (CT) results for 22 patients (14 male, eight female; mean age, 54 years) with cavernous transformation of the portal vein and no evidence of chronic liver disease at liver biopsy were retrospectively reviewed and compared with the CT results for 36 control subjects. Various morphologic changes in the hepatic lobes were qualitatively and quantitatively assessed by using the Student t test for unpaired data.


RESULTS
Qualitative analysis revealed the atrophy-hypertrophy complex in most (n = 20, 91%) of the patients with cavernous transformation and in no control subjects. Atrophy of the left lateral segment and right liver lobe was seen in 16 (73%) and seven (32%) patients, respectively. Hypertrophy of the caudate lobe and liver segment IV was identified in 19 (86%) and 11 (50%) patients, respectively. All mean caudate lobe volume index values and mean caudate lobe-to-right lobe ratio values were significantly greater (P < .05) in the cavernous transformation group than in the control group. The mean segment IV diameter was significantly greater (41.6 vs 28.1 mm, P < .001) in the patients with cavernous transformation. Hepatic nodules and hepatic contour nodularity were not seen in the patients with cavernous transformation.


CONCLUSIONS
The atrophy-hypertrophy complex is frequently observed in patients with cavernous transformation of the portal vein. Some findings, such as hypertrophy of the caudate lobe, mimic chronic liver disease or signs of portal hypertension, but left lateral segment atrophy and a normal or enlarged segment IV are distinctive findings of cavernous transformation.
Vilgrain
Valérie
V
Departments of Radiology and INSERM Unité 773 CRB3, Assistance Publique des Hôpitaux de Paris, Hôpital Beaujon, 100 bld Général Leclerc, 92110 Clichy, France. valerie.vilgrain@bjn.ap-hop
Condat
Bertrand
B
Bureau
Christophe
C
Hakimé
Antoine
A
Plessier
Aurélie
A
Cazals-Hatem
Dominique
D
Valla
Dominique C
DC
D000328:Adult; D000368:Aged; D001284:Atrophy; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed