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Portosystemic collateral vessels in liver cirrhosis

Philips CT Clinical Science Philips Healthcare • USA

A three-dimensional MDCT pictorial review

Moubarak E, Bouvier A, Boursier J, Lebigot J, Ridereau-Zins C, Thouveny F, Willoteaux S, Aubé C.

* Originally published in the October 2012 issue of Abdominal Imaging.
Portosystemic collateral vessels (PSCV) are a consequence of the portal hypertension that occurs in chronic liver diseases. Their prognosis is strongly marked by the risk of digestive hemorrhage and hepatic encephalopathy.

Materials and Methods
CT was performed with a 16-MDCT scanner. Maximum intensity projection and volume rendering were systematically performed on a workstation to analyze PSCV.

We describe the PSCV according to their drainage into either the superior or the inferior vena cava. In the superior vena cave group, we found gastric veins, gastric varices, esophageal, and para-esophageal varices. In the inferior vena cava group, the possible PSCV are numerous, with different sub groups: Gastro and spleno renal shunts, paraumbilical and abdominal wall veins, retroperitoneal shunts, mesenteric varices, gallbladder varices, and omental collateral vessels. Regarding clinical consequences esophageal and gastric varices are most frequently involved in digestive bleeding; splenorenal shunts often lead to hepatic encephalopathy; the paraumbilical vein is an acceptable derivation pathway for natural decompression of the portal system.

Knowledge of precise cartography of PSCV is essential to therapeutic decisions. MDCT is the best way to understand and describe the different types of PSCV.
For more information about this publication, check out the PubMed listing for this article.

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Jan 16, 2014

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Brilliance 16-slice
2012 scientific publications, abdomen, Body, gall bladder, hemorrhage, hypertension, liver, MIP

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