Skip to main content

Computed Tomography in Portal Hypertension

  • Chapter
Portal Hypertension

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 354 Accesses

Abstract

Computed tomography (CT) is not the primary imaging tool in patients with portal hypertension. Since it does not allow for measurement of flow direction, portal flow rates or pressure gradients, CT relies almost entirely on morphologic ehanges. These morphologie signs, however, can be securely appreciated given an examination technique that employs a sufficient amount of intravenous contrast material. Otherwise, the examination technique is robust: even a sub optimum choice of scan parameters will generally cause no misdiagnoses.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Baron RL (1994) Understanding and optimizing use of contrast material for CT of the liver. AJR 163 (2): 323–331

    Article  PubMed  CAS  Google Scholar 

  • Baron RL, Oliver JH 3rd, Dodd GD 3rd, Nalesnik M, Holbert BL, Carr B (1996) Hepatocellular carcinoma: evaluation with biphasic, contrast-enhanced, helical CT. Radiology. 199 (2): 505–511

    PubMed  CAS  Google Scholar 

  • Bayraktar Y, Balkanci F, Bayraktar M, Calguneri M (1997) Budd-Chiari syndrome: a common complication of Behcet’s disease. Am J Gastroenterol 92 (5): 858–862

    PubMed  CAS  Google Scholar 

  • Chezmar JL, Redvanly RD, Nelson RC, Henderson JM (1992) Persistence of portosystemic collaterals and splenomegaly on CT after orthotopic liver transplantation. AJR 159 (2): 317–320

    Article  PubMed  CAS  Google Scholar 

  • Cho KC, Patel YD, Wachsberg RH, Seeff J (1995) Varices in portal hypertension: evaluation with CT. Radiographics 15 (3): 609–6–22

    PubMed  CAS  Google Scholar 

  • Feliciano PD, Cullen JJ, Corson JD (1996) The management of extrahepatic portal vein aneurysms: observe or treat? HPB Surg 10 (2): 113–116

    Article  PubMed  CAS  Google Scholar 

  • Gollin G, Ward B, Meier GH, Sumpio BE, Gusberg RJ (1994) Central splanchnic venous thrombosis. Often unsuspected, usually uncomplicated. J Clin Gastroenterol 18 (2): 109–113

    Article  PubMed  CAS  Google Scholar 

  • Guermazi A, de Kerviler E, Zagdanski AM, Bourrier P, Attal P, Frija J (1996) Imaging findings in giant pseudotumoral paraesophageal varices. Eur Radiol 6 (4): 451–453

    PubMed  CAS  Google Scholar 

  • Han DC, Feliciano DV (1998) The clinical complexity of splenic vein thrombosis. Am Surg 64 (6): 558–561

    PubMed  CAS  Google Scholar 

  • Harbin WP, Robert NJ, Ferrucci JT (1980) Diagnosis of cirrhosis based on regional changes of hepatic morphology: Radiological and pathological analysis. Radiology 135:273

    PubMed  CAS  Google Scholar 

  • Hoebeke Y, Scotte M, Leblanc I, Michot F, Teniere P (1993) L‘anevrysme de l‘artere splenique: une etiologie exceptionnelle d‘hypertension portale segmentaire. Ann Chir 47 (6): 557–558

    PubMed  CAS  Google Scholar 

  • Horton KM, Fishman EK (1998) Paraumbilical vein in the cirrhotic patient: imaging with 3D CT angiography. Abdom Imaging 23 (4): 404–408

    Article  PubMed  CAS  Google Scholar 

  • Itai Y, Kurosaki Y, Saida Y, Niitsu M, Kuramoto K (1994) CT and MRI in detection of intrahepatic portosystemic shunts in patients with liver cirrhosis. J Comput Assist Tomogr 18 (5): 768–773

    PubMed  CAS  Google Scholar 

  • Ito K, Higuchi M, Kada T, et al (1997) CT of acquired abnormalities of the portal venous system. Radiographics 17 (4): 897–917

    PubMed  CAS  Google Scholar 

  • Jarlaud T, Teisseyre A, Sans N, Fajadet P, Giron J, Fourcade D, Railhac JJ (1998) Une pseudotumeur mediastino-hilaire rare: varices oesophagiennes et azygos. J Radiol 79 (4): 348–350

    PubMed  CAS  Google Scholar 

  • Jörgensen M, Prokop M, Oldhafer KJ, Galanski (1995) Dual phase spiral CT for preoperative assessment of liver lesions. Eur J Radiol 5(P):79

    Article  Google Scholar 

  • Kawasaki T, Kambayashi J, Sakon M, Shiba E, Yokota M, Doki Y, Suehisa E, Nishimura K, Amino N, Miyai K, et al (1993) Portal vein calcification: a clinical review of the last 50 years and report of a case associated with dysplasminogenemia. Surg Today 23 (2): 176–181

    Article  PubMed  CAS  Google Scholar 

  • Kevorkian JP, Michel PL, Faintuch JM, Dadez E, Bonnet D, Bigot JM, Cormier JM, Acar J (1993) Insuffisance cardiaque globale secondaire a une fistule arterio-veineuse hepaticoportale. Apropos d‘une observation et revue de la litterature. Arch Mal Coeur Vaiss 86 (3): 371–375

    CAS  Google Scholar 

  • Kilicoglu G, Eren N, Celik L, Tasel B (1998) An unusuallocalization of massive portasystemic collaterals: CT angiographic demonstration. Eur J Radiol 8 (4): 571–572

    Article  CAS  Google Scholar 

  • Kraus BB, Ros PR, Abbitt PL, Kerns SR, Sabatelli FW (1995) Comparison of ultra sound, CT, and MR imaging in the evaluation of candidates for TIPS. J Magn Reson Imaging 5 (5): 571–578

    Article  PubMed  CAS  Google Scholar 

  • Kuramitsu T, Komatsu M, Matsudaira N, Naganuma T, Niizawa M, Zeniya A, Yoshida T, Toyoshima I, Chiba M, Masamune O (1998) Portal-systemic encephalopathy from a spontaneous gastrorenal shunt diagnosed by three-dimensional computed tomography and treated effectively by percutaneous vascular embolization. Liver 18 (3): 208–212

    PubMed  CAS  Google Scholar 

  • Lafortune M, Canstanin A, Breton G, et al. The recanalized umbilical vein in portal hypertension: a myth. AJR 1985; 144:549–553

    Article  PubMed  CAS  Google Scholar 

  • Lee SJ, Lee KS, Kim SA, Kim TS, Hwang JH, Lim JH (1998) Computed radiography of the ehest in patients with paraesophageal varices: diagnostic accuracy and characteristic findings. AJR 170 (6): 1527–31

    Article  PubMed  CAS  Google Scholar 

  • Lerch R, Wolfle KD, Loeprecht H (1996) Superior mesenteric venous aneurysm. Ann Vase Surg 10 (6): 582–588

    Article  CAS  Google Scholar 

  • Levine CD, Gonzales RN, Wachsberg RH (1997) CT evaluation of pararectal varices. J Comput Assist Tomogr 21 (6): 992–925

    Article  PubMed  CAS  Google Scholar 

  • Lim JH, Park JH, Auh YH (1992) Membranous obstruction of the inferior vena cava: comparison of findings at sonography, CT, and venography. AJR 159 (3): 515–520

    Article  PubMed  CAS  Google Scholar 

  • Lin CY, Lin PW, Tsai HM, Lin XZ, Chang TT, Shin JS (1994) Influence of paraesophageal venous collaterals on efficacy of endoscopic sclerotherapy for esophageal varices. Hepatology 19 (3): 602–608

    Article  PubMed  CAS  Google Scholar 

  • Lopez Machado E, Mallorquin Jimenez F, Medina Benitez A, Ruiz Carazo E, Cubero Garcia M (1998) Aneurysms of the portal venous system: ultrasonography and CT findings. Eur J Radiol 26 (2): 210–214

    Article  PubMed  CAS  Google Scholar 

  • Marn CS, Francis IR (1992) CT of portal venous occlusion. AJR 159:717–72

    Article  PubMed  CAS  Google Scholar 

  • Mathieu D, Grenier P, Larde D, Vasile N (1984) Portal vein involvement in hepatocellular carcinoma: dynamic CT features. Radiology 152:127–132

    PubMed  CAS  Google Scholar 

  • McLoughlin RF, Dashefsky SM, Cooperberg PL, Mathieson JR (1995) Spontaneous portal right renal vein shunt in portal hypertension. J Ultrasound Med 14 (12): 959–961

    PubMed  CAS  Google Scholar 

  • Mergo PJ, Ros PR (1998) Imaging of diffuse liver disease. Radiol Clin North Am 36 (2): 365–375

    Article  PubMed  CAS  Google Scholar 

  • Mori H, Hayashi K, Uetani m, Matsuoka Y, Iwao M, Maeda H (1987) High -attenuation recent thrombus in the portal vein: CT demonstration and clinical significance. Radiology 163:353–356

    PubMed  CAS  Google Scholar 

  • Mori H, Miyake H, Aikawa H et al. (1991) Dilated posterior superior pancreaticoduodenal veins: recognition with CT and clinical significance in patients with pancreaticobiliary carcinomas. Radiology 181:793–800

    PubMed  CAS  Google Scholar 

  • Nagafuchi Y, Watanabe H, Kitahara K, Okamoto K, Hirata K, Tabaru A, Otsuki M, Nakata H, Itho H (1996) Intrahepatic portosystemic venous shunt: report of two cases assessed by helical computed tomography. Scand J Gastroenterol 31 (11):1132–1135

    Article  PubMed  CAS  Google Scholar 

  • Ohhira M, Ohta H, Ohhira M, Matsumoto A, Ohtake T, Fujimoto Y, Murazumi K, Ono M, Kohgo Y (1998) Altered intrahepatic pathway of para-umbilical vein in portal hypertension.J Gastroenterol Hepatol 13 (7): 691–695

    Article  PubMed  CAS  Google Scholar 

  • Okuda K, Musha H, Yoshida T, et al. (1975) Demonstration of growing casts of hepatocellular carcinoma in the portal vein by celiac angiography: the thread and streak sign. Radiology 117:303–309

    PubMed  CAS  Google Scholar 

  • Oliver JH 3rd, Baron RL, Federle MP, Rockette HE Jr (1996) Detecting hepatocellular carcinoma: value of unenhanced or arterial phase CT imaging or both used in conjunctionwith conventional portal venous phase contrast enhanced CT imaging. AJR 167 (1): 71–77

    Article  PubMed  Google Scholar 

  • Parvey HR, Raval B, Sandler CM (1994) Portal vein thrombosis: imaging findings. AJR 162 (1): 77–81

    Article  PubMed  CAS  Google Scholar 

  • Pickhardt PJ, Balfe DM (1998) Portal vein calcification and associated biliary stricture in idiopathic portal hypertension (Banti’s syndrome). Abdom Imaging 23 (2): 180–182

    Article  PubMed  CAS  Google Scholar 

  • Realini S, Reiner M, Bernasconi S, Pedrinis E (1993) Fibrose retroperitoneale et hypertension portale. Schweiz Med Wochenschr 13, 123 (1-2): 26–28

    PubMed  CAS  Google Scholar 

  • Rozenblit G, Dei Guercio LR, Savino J, Cerabona T, Policastro A, McPhee M (1996) Splenic venous hypertension presenting as variceal hemorrhage caused by portal hypertension. J Am Coll Surg 182 (1): 63–68

    PubMed  CAS  Google Scholar 

  • Seitz K, Wermke W (1995) Portale Hypertension - derzeitiger Stand der sonographischen Diagnostik. Z Gastroenterol 33 (6): 349–361

    PubMed  CAS  Google Scholar 

  • Sherlock S, Dooley J (1993) Diseases of the liver and biliary system. Blackwell Scientific, Oxford, pp 132–178

    Google Scholar 

  • Shirohara H, Endo M, Sakai K, Tabaru A, Otsuki M (1996) Enlarging splenic vein aneurysm associated with stagnation of splenic venous blood flow. Am J Gastroenterol 91 (2): 385–387

    PubMed  CAS  Google Scholar 

  • Strassburg CP, Bleck JS, Rosenthai H, Meyer HJ, Gebel M, Manns MP (1996) Diarrhea, massive ascites, and portal hypertension: rare case of a splenic arterio-venous fistula. Z Gastroenterol 34 (4): 243–249

    PubMed  CAS  Google Scholar 

  • Takahashi T, Katoh H, Dohke M, Okushiba S (1997) A giant hepatic hemangioma with secondary portal hypertension: a case report of successful surgical treatment. Hepatogastroenterology 44 (16): 1212–1214

    PubMed  CAS  Google Scholar 

  • Uddin W, Ramage JK, Portmann B, Wilson P, Benjamin I, Tan KC, Williams R (1995) Hepatic venous outflow obstruction in patients with polycystic liver disease: pathogenesis and treatment. Gut 36 (1): 142–145

    Article  PubMed  CAS  Google Scholar 

  • Ueda K, Matsui O, Kadoya M, Yoshikawa J, Gabata T, Kawamori Y, Takashima T (1998) CTAP in Budd-Chiari syndrome: evaluation of intrahepatic portal flow. Abdom Imaging 23 (3): 304–308

    Article  PubMed  CAS  Google Scholar 

  • Wachsberg RH, Yaghmai V, Javors BR, Levine CD, Simmons MZ, Maldjian PD (1995) Cardiophrenic variecs in portal hypertension: evaluation with CT. Radiology. 195 (2): 553–556

    PubMed  CAS  Google Scholar 

  • Walsh G, Williams MP (1995) Case report: giant pararectal varices -computed tomographie appearances. Br J Radiol 68 (806): 203–204

    Article  PubMed  CAS  Google Scholar 

  • Wiersema MJ, Chak A, Kopecky KK, Wiersema LM (1995) Duplex Doppler endosonography in the diagnosis of splenic vein, portal vein, and portosystemic shunt thrombosis. Gastrointest Endosc 42 (1): 19–26

    Article  PubMed  CAS  Google Scholar 

  • Wolf S, Berger H, Jauch KW (1998) Arterioportal fistula with portal hypertension after liver trauma and resection: a case report and review of the literature. Hepatogastroenterology 45 (21): 821–826

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Prokop, M. (2000). Computed Tomography in Portal Hypertension. In: Rossi, P., Ricci, P., Broglia, L. (eds) Portal Hypertension. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57116-9_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-57116-9_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63006-4

  • Online ISBN: 978-3-642-57116-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics