title: Portal biliopathy diagnosed using color Doppler and contrast-enhanced ultrasound.
abstract: Portal biliopathy is a morphological abnormality of the biliary ductal and gallbladder wall associated with portal hypertension. A patient with essential thrombocythemia was initially diagnosed with extrahepatic portal vein obstruction (EHPVO). The contrast-enhanced computed tomography (CT) findings were similar to those of cholangiocarcinoma or sclerosing cholangitis. However, color Doppler and contrast-enhanced ultrasound (US) were more specific. The paracholedocheal veins around the bile ducts appeared as beads soon after the injection of contrast medium, followed by linear enhancement of the epicholedochal veins and the gradual enhancement of the whole bile ducts. These findings led to a diagnosis of portal biliopathy, which prevented the patient from having to endure hazardous procedures such as bile duct biopsies. Color Doppler and contrast-enhanced US findings are useful for diagnosing or ruling out portal biliopathy in patients who present with EHPVO.
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nunoi
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Hironori
authors.initials: H
authors.lastname: Ochi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Koizumi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tokumoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Fujimasa
authors.initials: F
authors.lastname: Tada
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Takaharu
authors.initials: T
authors.lastname: Tsuda
authors.forename: Teruhito
authors.initials: T
authors.lastname: Mochizuki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D018281:Cholangiocarcinoma / Q000175:diagnosis; D015209:Cholangitis, Sclerosing / Q000175:diagnosis; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis; D003097:Collateral Circulation; D003135:Common Bile Duct / Q000002:abnormalities* / Q000098:blood supply / Q000000981:diagnostic imaging; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005704:Gallbladder / Q000098:blood supply; D006392:Hemangioma, Cavernous / Q000175:diagnosis; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D006975:Hypertension, Portal / Q000209:etiology*; D021621:Imaging, Three-Dimensional; D008551:Melena / Q000209:etiology; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D011169:Portal Vein / Q000000981:diagnostic imaging*; D015911:Sclerotherapy; D013920:Thrombocythemia, Essential / Q000150:complications / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014648:Varicose Veins / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D054079:Vascular Malformations / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D006918:Hydroxyurea