| Vascular and biliary abnormalities mimicking cholangiocarcinoma in patients with cavernous transformation of the portal vein: role of color Doppler sonography. | |
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MedLine Citation:
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PMID: 17646372 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to describe and evaluate the sonographic and color Doppler features of tumorlike biliary and venous changes in patients with cavernous transformation of the portal vein (CTPV). METHODS: The sonographic studies of 24 patients with CTPV were reviewed. Sonographic evaluation of the biliary system included measurement of intrahepatic and extrahepatic biliary duct caliber changes and common bile duct (CBD) wall thickening and character. Color Doppler features of the portoportal collateral circulation at various locations (intrahepatic, periportal, gallbladder, pancreatic, and gastric regions) were carefully evaluated. RESULTS: Biliary abnormalities were detected in 13 (54%) of 24 patients with CTPV. All 13 patients (100%) had intrahepatic biliary dilatation; 11 patients (85%) had CBD abnormalities: diffuse CBD wall thickening causing diffuse narrowing of the true lumen in 7 (54%) and CBD dilatation proximal to the focal area of narrowing due to pericholedochal compressing venous collaterals in 4 (30%). A tumorlike solid mass appeared on the gray scale images of 2 patients (8%): 1 at the porta hepatis and the other at the pancreatic head level. Color Doppler imaging evaluation showed venous-type flow, suggesting a bulk of varicosities. CONCLUSIONS: Portoportal collaterals in patients with CTPV may alter the biliary and venous systems, causing biliary wall thickening, stenosis, intrahepatic and extrahepatic dilatation, and pseudotumors. Detailed sonographic and color Doppler imaging assessment can show and facilitate the correct diagnosis of those changes, thus avoiding the need for a more invasive modality such as endoscopic retrograde cholangiopancreatography or a more expensive investigation such as magnetic resonance cholangiopancreatography. |
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Authors:
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Ada Kessler; Moshe Graif; Fred Konikoff; Diego Mercer; Ran Oren; Michal Carmiel; Arye Blachar |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Volume: 26 ISSN: 0278-4297 ISO Abbreviation: J Ultrasound Med Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-07-24 Completed Date: 2007-09-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8211547 Medline TA: J Ultrasound Med Country: United States |
Other Details:
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Languages: eng Pagination: 1089-95 Citation Subset: IM |
Affiliation:
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Division of Ultrasound, Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. kesslera@tasmc.health.gov.il |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Bile Duct Diseases / pathology, ultrasonography* Bile Duct Neoplasms / ultrasonography Bile Ducts / pathology*, ultrasonography Child Cholangiocarcinoma / ultrasonography Collateral Circulation* Diagnosis, Differential Female Humans Hypertension, Portal / etiology Male Middle Aged Portal Vein / pathology*, ultrasonography Retrospective Studies Ultrasonography, Doppler, Color* Venous Thrombosis / complications |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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