Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of the collateral vessels |
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Authors: | Bin Song Pengqui Min M Oudkerk Xiangping Zhou Yinghui Ge Jun Xu Weixia Chen Xian Chen |
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Institution: | (1) Department of Radiology, The First University Hospital, West China University of Medical Sciences, Guo Xue Xiang 37, Chengdu, Sichuan Province 610041, People's Republic of China, CN;(2) Department of Radiology, Dujiangyan Municipal People's Hospital, Dujiangyan City, Sichuan Province 630000, People's Republic of China, CN;(3) Department of Radiology, Dr. Daniel den Hoed Cancer Center, University Hospital Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands, NL |
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Abstract: | Background: We investigated the constituting collateral vessels in cavernous transformation of the portal vein (CTPV) caused by tumor
thrombosis of hepatocellular carcinoma (HCC) by using contrast-enhanced spiral computed tomographic (CT) examination.
Methods: Fifty-four histopathologically proven HCC patients with tumor thrombosis-induced CTPV were retrospectively included and assigned
to cirrhosis negative (n= 31) and positive (n= 23) groups. Another 15 cirrhotic patients with portal hypertension but no HCC and CTPV were used for comparison. Standardized
dual-phase contrast-enhanced spiral CT was performed for all patients. CT appearances of the collateral vessels of CTPV were
observed, and their visualization rates were analyzed.
Results: Biliary (cystic and paracholedochal veins) and gastric (left and right gastric veins) branches of the portal vein were the
most frequently visualized collateral vessels of CTPV. There was a marked difference in CT visualization rates for biliary
branches between patients with and without CTPV (83–94% vs. 0). No difference existed in visualization rates for gastric branches
across the three groups (77–87% for left gastric, 58–61% for right gastric vein).
Conclusions: Biliary and gastric branches of the portal vein are the major collateral vessels of CTPV. The intergroup differences in CT
visualization rates may provide clues to the roles that they might play in the hemodynamic adaptation process of CTPV.
Received: 13 October 1999/Accepted: 12 January 2000 |
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Keywords: | : Portal venous system— Cavernous transformation— Collateral circulation— Computed tomography spiral |
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