title: Portosystemic collateral vessels in liver cirrhosis: a three-dimensional MDCT pictorial review.
abstract: OBJECTIVE
  Portosystemic collateral vessels (PSCV) are a consequence of the portal hypertension that occurs in chronic liver diseases. Their prognosis is strongly marked by the risk of digestive hemorrhage and hepatic encephalopathy.
  
  
  METHODS
  CT was performed with a 16-MDCT scanner. Maximum intensity projection and volume rendering were systematically performed on a workstation to analyze PSCV.
  
  
  RESULTS
  We describe the PSCV according to their drainage into either the superior or the inferior vena cava. In the superior vena cave group, we found gastric veins, gastric varices, esophageal, and para-esophageal varices. In the inferior vena cava group, the possible PSCV are numerous, with different sub groups: gastro and spleno renal shunts, paraumbilical and abdominal wall veins, retroperitoneal shunts, mesenteric varices, gallbladder varices, and omental collateral vessels. Regarding clinical consequences esophageal and gastric varices are most frequently involved in digestive bleeding; splenorenal shunts often lead to hepatic encephalopathy; the paraumbilical vein is an acceptable derivation pathway for natural decompression of the portal system.
  
  
  CONCLUSIONS
  Knowledge of precise cartography of PSCV is essential to therapeutic decisions. MDCT is the best way to understand and describe the different types of PSCV.
authors: Department of Radiology, Angers University Hospital, Angers, France.
authors: Elie
authors: E
authors: Moubarak
authors: Antoine
authors: A
authors: Bouvier
authors: Jérôme
authors: J
authors: Boursier
authors: Jérôme
authors: J
authors: Lebigot
authors: Catherine
authors: C
authors: Ridereau-Zins
authors: Francine
authors: F
authors: Thouveny
authors: Serge
authors: S
authors: Willoteaux
authors: Christophe
authors: C
authors: Aubé
mesh_terms: D003097:Collateral Circulation; D003287:Contrast Media; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D011168:Portal System / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000209:etiology
chemical_list: D003287:Contrast Media