Cavernous transformation of the portal vein (CTPV): role of color Doppler sonography in the diagnosis |
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| Institution: | 1. Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan;2. Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA;3. Monitoring and Diagnostic Division, AtheroPoint?, Roseville, CA, USA;4. Department of Electrical Engineering, NIT Raipur, Chhattisgarh, India;5. Cardiovascular Medicine, National Center for Global Health and Medicine, Tokyo, Japan;6. Department of Bioengineering, University of Louisville, USA;7. Department of Radiology, University of Cagliari, Italy;8. Vascular Screening and Diagnostic Centre, London, England;9. Vascular Diagnostic Centre, University of Cyprus, Nicosia, Cyprus;10. CorVasc Vascular Laboratory, 8433 Harcourt Rd #100, Indianapolis, IN, USA;11. UC Davis Vascular Centre, University of California, Davis, CA, USA;12. Brain and Mind Research Institute and Department of Radiology, Weill Cornell Medical College, NY, USA;13. Department of Electrical Engineering, University of Idaho (Affl.), ID, USA;1. Molecular Characterization and Clinical Assay Development Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland;2. Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas;3. Department of Pathology, School of Medicine, Yale University, New Haven, Connecticut;4. Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts;5. Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland;1. Department of Cardiology, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy;2. Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy;1. Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL;2. Division of Interventional Radiology, University of Alabama at Birmingham, Birmingham, AL;1. Department of Medical Oncology, Bellaria-Maggiore Hospitals, Azienda USL – IRCCS Institute of Neurological Sciences, Bologna, Italy;2. Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University, of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy;3. Pathology Department, Verona Hospital, Verona, Italy;4. Department of Neuroradiology, Bellaria-Maggiore Hospitals, Azienda USL – IRCCS Institute of Neurological Sciences, Bologna, Italy;5. Department of Neurosurgery, Bellaria Hospital – IRCCS Institute of Neurological Sciences, Azienda USL, Bologna, Italy;6. Department of Radiotherapy Unit, CRO, Aviano, Italy;7. Department of Neuroscience and Neurosurgery, San Bortolo Hospital, Vicenza, Italy;8. Department of Neurosurgery I, Careggi University Hospital, Firenze, Italy;9. Section of Neurosurgery, Department of Neuroscience, University of Verona, Verona, Italy;10. Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University Hospital, Padova, Italy;11. Department of Medicine (DIMES) – Anatomic Pathology Unit, Bellaria Hospital, University of Bologna, Bologna, Italy;12. Department of Neuroradiology, Parma University Hospital, Parma, Italy;1. Barcelonaβeta Brain Research Center, Barcelona, Spain;2. Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain;3. Department of Physiological Sciences II, School of Medicine, University of Barcelona (UB), Barcelona, Spain;4. Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain;5. Pasqual Maragall Foundation, Barcelona, Spain;6. Universitat Pompeu Fabra, Barcelona, Spain |
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| Abstract: | Objective: The aim of this study was to investigate the hemodynamics of cavernous transformation of the portal vein (CTPV) using color Doppler sonography and to correlate it with sonographic findings and clinical manifestations. Methods: Using color Doppler sonography, we studied 25 patients who satisfied the sonographic diagnostic triad of CTPV and compared clinical, sonographic, and color Doppler findings. We also compared the hemodynamics of the liver vasculature in a group of CTPV patients with that in a group of normal subjects. Results: We could differentiate five cases of dilated hepatic artery without formation of CTPV from 20 cases of CTPV. In 13 cases of CTPV, the cause of the portal vein thrombosis prior to CTPV could be determined. Two types of CTPV were distinguished: linear type (small diameter without tortuosity) and tortuous type (large diameter with tortuosity). There were no particular tendencies in the cause or distribution between the two groups, but the flow velocity was significantly higher in the tortuous type than in the linear type. Slow continuous flow with little or no respiratory variations was observed in CTPV by color Doppler sonography in agreement with previous reports, and the velocity of CTPV was slower than that of the portal flow in normal subjects. The flow velocity was not related to the cause or the presence of developed collaterals, and the flow direction was always hepatopetal. Conclusion: Color Doppler sonography was considered to be the most useful modality for the diagnosis and comprehension of the hemodynamics of CTPV. |
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