title: Portal cholangiopathy: radiological classification and natural history.
abstract: OBJECTIVE
  Portal cholangiopathy (PC) is identified in over 80% of patients with portal vein thrombosis (PVT), but the true impact of this condition is not well known. This study investigated the relationship between cholangiographic abnormalities and clinical symptoms and their evolution over time.
  
  
  METHODS
  67 consecutive patients with non-tumoral non-cirrhotic PVT following a standardised diagnostic protocol were studied. Findings at magnetic resonance angiography and cholangiography (MRA/MRC) were classified as no PC, grade I PC (minimal irregularities), grade II PC (stenosis without dilation) and grade III PC (stenosis with dilation). These changes were related to the presence of symptoms.
  
  
  RESULTS
  22 patients were diagnosed with acute PVT and 45 presented with chronic PVT. Overall, 52 patients had PC (6 grade I, 12 grade II and 34 grade III). 14 patients developed symptoms, all of whom had grade III PC. 30% of patients with acute PVT developed grade III PC within 1 year. In those without grade III PC, follow-up MRC showed no progression of the biliary lesions to grade III. The 5-year probability of developing symptoms of PC after acute PVT was 19%. In 45 patients with chronic PVT, MRA/MRC showed grade III PC in 26. In those without grade III PC, no progression of PC was observed at further follow-up MRC. The prevalence of symptoms of PC in these patients was 22%.
  
  
  CONCLUSIONS
  PC is a frequent complication that develops and stabilises early after PVT and becomes symptomatic in its more severe form (grade III). These data suggest that follow-up MRA/MRC is not mandatory and strategies to prevent the development of symptoms of PC should be tested in patients with grade III PC.
authors.affiliation: Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Barcelona 08036, Spain.
authors.forename: Elba
authors.initials: E
authors.lastname: Llop
authors.forename: Carmen
authors.initials: C
authors.lastname: de Juan
authors.forename: Susana
authors.initials: S
authors.lastname: Seijo
authors.forename: Angeles
authors.initials: A
authors.lastname: García-Criado
authors.forename: Juan G
authors.initials: JG
authors.lastname: Abraldes
authors.forename: Jaume
authors.initials: J
authors.lastname: Bosch
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: García-Pagán
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000465:Algorithms; D001660:Biliary Tract Diseases / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002779:Cholestasis / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020246:Venous Thrombosis / Q000150:complications*; D055815:Young Adult