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Paraumbilical collateral veins on MRI as possible protection against portal venous thrombosis in candidates for liver transplantation

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Abstract

Background

We retrospectively evaluate the potential protective influence of patent paraumblical vein (PUV) collaterals against portal vein (PV) thrombosis and reduced PV diameter in candidates for orthotopic liver transplant (OLT)

Methods

Dynamic 3D contrast-enhanced MRI at 1.5T was obtained in 309 patients with cirrhosis without evidence of malignancy. All MR studies were reviewed by one reader for PUV collaterals, PV thrombosis and PV diameter. Statistical analysis was performed by Fisher exact tests; 50 selected studies were reviewed independently by two additional readers to determine interobserver agreement via intraclass correlation coefficient (ICC).

Results

Patent PUV was noted in 119 of 309 patients (38.5%). Mean PV diameter was 13.4 ± 3.0 mm in patients with PUV compared with 11.3 ± 3.6 mm without PUV (P < 0.01). Main PV thrombosis was present in 13 of 309 patients (4.2%) and significantly more frequent in those without PUV than with PUV (6.3% vs. 0.8%, P < 0.05). ICC indicated almost perfect agreement among three readers for presence of PUV collaterals (ICC = 0.91) and PV thrombosis (ICC = 0.96).

Conclusion

Our results suggest that patients with patent PUV appear less likely to develop main PV thrombosis or small PV diameter, suggesting a protective effect of PUV on PV patency.

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Authors and Affiliations

  1. Department of Radiology, Thomas Jefferson University Hospital, 132 South 10th St 1094 Main Building, Philadelphia, PA, 19107, USA

    Sachit K. Verma, Donald G. Mitchell, Yulia Lakhman, Diane Bergin, Ronald J. Dolin & Laurence Parker

  2. Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Cataldo Doria

Authors
  1. Sachit K. Verma
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  2. Donald G. Mitchell
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  3. Yulia Lakhman
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  4. Diane Bergin
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  7. Laurence Parker
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Correspondence to Donald G. Mitchell.

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Verma, S.K., Mitchell, D.G., Lakhman, Y. et al. Paraumbilical collateral veins on MRI as possible protection against portal venous thrombosis in candidates for liver transplantation. Abdom Imaging 33, 536–541 (2008). https://doi.org/10.1007/s00261-007-9333-y

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