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Semin intervent Radiol 2023; 40(01): 033-037
DOI: 10.1055/s-0043-1764431
Review Article

Portal Vein Thrombosis: Introduction to Imaging and Etiology

Sebouh Gueyikian
1   Section of Interventional Radiology, Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois
,
Hector Ferral
2   Department of Radiology, Louisiana State University Health Sciences Center New Orleans, New Orleans, Louisiana
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Abstract

Portal vein thrombosis (PVT) is a complex medical condition that presents differently depending on the etiology. Appropriate imaging is necessary to determine the extent of clot, as well as its chronicity. While determining the characteristics of the PVT, imaging may also reveal the underlying cause of PVT. The purpose of this article is to describe the most common imaging modalities used in the evaluation of PVT, and to describe the findings of PVT.

Keywords

portal vein thrombus - imaging - etiologies - transjugular intrahepatic portosystemic shunt - interventional radiology


Publication History

Article published online:
04 May 2023

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  • References

  • 1 Northup PG, Garcia-Pagan JC, Garcia-Tsao G. et al. Vascular liver disorders, portal vein thrombosis, and procedural bleeding in patients with liver disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology 2021; 73 (01) 366-413
    CrossrefPubMedGoogle Scholar
  • 2 Simonetto DA, Singal AK, Garcia-Tsao G, Caldwell SH, Ahn J, Kamath PS. ACG clinical guideline: disorders of the hepatic and mesenteric circulation. Am J Gastroenterol 2020; 115 (01) 18-40
    CrossrefPubMedGoogle Scholar
  • 3 Bhangui P, Lim C, Levesque E. et al. Novel classification of non-malignant portal vein thrombosis: a guide to surgical decision-making during liver transplantation. J Hepatol 2019; 71 (05) 1038-1050
    CrossrefPubMedGoogle Scholar
  • 4 Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases. Hepatology 2017; 65 (01) 310-335
    CrossrefPubMedGoogle Scholar
  • 5 Tessler FN, Gehring BJ, Gomes AS. et al. Diagnosis of portal vein thrombosis: value of color Doppler imaging. AJR Am J Roentgenol 1991; 157 (02) 293-296
    CrossrefPubMedGoogle Scholar
  • 6 Bach AM, Hann LE, Brown KT. et al. Portal vein evaluation with US: comparison to angiography combined with CT arterial portography. Radiology 1996; 201 (01) 149-154
    CrossrefPubMedGoogle Scholar
  • 7 De Gaetano AM, Lafortune M, Patriquin H, De Franco A, Aubin B, Paradis K. Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography. AJR Am J Roentgenol 1995; 165 (05) 1151-1155
    CrossrefPubMedGoogle Scholar
  • 8 Catalano OA, Choy G, Zhu A, Hahn PF, Sahani DV. Differentiation of malignant thrombus from bland thrombus of the portal vein in patients with hepatocellular carcinoma: application of diffusion-weighted MR imaging. Radiology 2010; 254 (01) 154-162
    CrossrefPubMedGoogle Scholar
  • 9 Sherman CB, Behr S, Dodge JL, Roberts JP, Yao FY, Mehta N. Distinguishing tumor from bland portal vein thrombus in liver transplant candidates with hepatocellular carcinoma: the A-VENA criteria. Liver Transpl 2019; 25 (02) 207-216
    CrossrefPubMedGoogle Scholar
  • 10 Intagliata NM, Caldwell SH, Tripodi A. Diagnosis, development, and treatment of portal vein thrombosis in patients with and without cirrhosis. Gastroenterology 2019; 156 (06) 1582-1599.e1
    CrossrefPubMedGoogle Scholar
  • 11 Naymagon L. Venous thrombosis of the liver: current and emerging concepts in management. Transl Res 2020; 225: 54-69
    CrossrefPubMedGoogle Scholar
  • 12 Ferral H. Diagnosis and management of acute and chronic portomesenteric venous thrombosis. Dig Dis Interv 2022; 6: 113-120
    Article in Thieme ConnectPubMedGoogle Scholar