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Portal venous thrombus

Case Study
Rossi, Santiago, M.D. Centro de Diagnostico Dr. Enrique Rossi • Argentina
Dr. Volpacchio, Mariano, M.D. Centro de Diagnostico Dr. Enrique Rossi • Argentina

Patient history

60-year-old male with a history of a resected colon carcinoma. Follow-up CT (not shown) revealed a hyperattenuating area in right lobe of the liver raising concern for metastatic disease.

MR examination

Achieva 3.0T TX with MultiTransmit was used with the SENSE Torso XL coil.

Images with superb resolution were acquired with the patient supine using respiratory-triggered and breath-hold sequences.

Results

 T2W
T2W



 DWI
DWI


 THRIVE
THRIVE


 MIP
MIP

 

No abnormality was seen on T2-weighted images and DWI.
The fat-suppressed 3D gradient echo T1-weighted (THRIVE) reveals an area of early enhancement not seen on subsequent portal venous phase. However, a linear filling defect is detected in a portal venous radicle, consistent with portal venous thrombus. This post-operative finding was deemed to be responsible for the abnormal area of enhancement excluding recurrent disease. Notice abrupt amputation of the portal vein branch on reformatted coronal MIP image and subsegmental venous thrombus on reformatted coronal MIP image.

Diagnosis

The MR examination revealed a portal venous thrombus.

Impact of upgrade from Achieva 1.5T XR to Achieva 3.0T TX

Many studies have much higher spatial resolution. In body imaging, sequences such as eTHRIVE and 4D dynamic perform well. Study times are maintained the same as with 1.5T, but image quality and resolution have improved.


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Case Study
Achieva 1.5T, Achieva 3.0T
Body, colon carcinoma, liver, metastasis, MultiTransmit, SENSE Torso XL coil
 

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