Liver Metastases Imaging: Practice Essentials, Radiography, Computed Tomography
There is controversy regarding portal and hepatic vein invasion. Some authors believe that vascular involvement is more a ... is placed percutaneously into the superior mesenteric or splenic artery so that CT can be performed during the portal venous ... Anomalous peripheral venous drainage, local variations in portal perfusion, and mixing from nonenhancing splenic venous blood ... The liver is imaged in the portal venous phase when maximum liver-to-lesion attenuation difference occurs. Because the portal ...
Asplenia and Polysplenia Imaging: Practice Essentials, Radiography, Computed Tomography
A preduodenal portal vein is characterized by an anterior course of the superior mesenteric venous-portal junction ventral to ... and aberrant vascular structures and vascular connections. Each of these abnormalities is derived from an embryologic inability ... This image shows that the anomalous vessel bypasses the portal vein and connects to a hepatic vein. Note the abrupt caliber ... This image shows that the anomalous vessel bypasses the portal vein and connects to a hepatic vein. Note the abrupt caliber ...
Hepatoblastoma Imaging: Practice Essentials, Radiography, Computed Tomography
Venous-phase image demonstrates occlusion of the right portal vein and a filling defect in the proximal left portal vein ... Information about the vascular anatomy is crucial for surgical planning. Courtesy of Fredric Hoffer, MD, St. Jude Childrens ... Arterial-phase image demonstrates a replaced right hepatic artery (straight arrow) originating from the superior mesenteric ... Venous-phase image demonstrates occlusion of the right portal vein and a filling defect in the proximal left portal vein ...
Chronic Pancreatitis Imaging: Practice Essentials, Radiography, Computed Tomography
Portal and/or splenic vein thrombosis and associated collateral venous channels are better delineated during the portal venous ... The union of the superior mesenteric and splenic veins, which forms the portal vein posteriorly, marks the anatomic position of ... Vascular abnormalities are usually minimal in patients who have had the disease for less than 2 years. The tortuosity of the ... shows an occluded splenic vein and a large peripancreatic collateral vein that drains into the portal vein. View Media Gallery ...
Esophageal Varices Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography
They are native veins that serve as collaterals to the central venous circulation when flow through the portal venous system or ... Esophageal and paraesophageal varices are abnormally dilated veins of the esophagus. ... PV = portal vein; SMV = superior mesenteric vein; SV = splenic vein. Courtesy of Ali Shirkhoda, MD, William Beaumont Hospital, ... Arrow points to enhancing vascular structures within the wall of the esophagus projecting into the lumen. View Media Gallery ...
Hepatocellular Carcinoma (HCC): Practice Essentials, Anatomy, Pathophysiology
The portal vein is confluence of the splenic vein and the superior mesenteric vein, which drain the intestines, pancreas, ... The primary venous drainage of the liver is through three large hepatic veins that enter the inferior vena cava adjacent to the ... The vascular supply of the liver includes two sources of inflow that travel in the hepatoduodenal ligament, as follows:. * ... each of which is supplied by a branch of the portal vein. The right hemiliver drains via the right hepatic vein. The left ...
Upper Gastrointestinal Bleeding Imaging: Practice Essentials, Radiography, Computed Tomography
Portal venous phase of a superior mesenteric angiogram showing portal vein occlusion and gastroesophageal varices (arrow) (same ... In the setting of aneurysms and pseudoaneurysm, magnetic resonance angiography (MRA) may be helpful in depicting the vascular ... Portal venous phase of a superior mesenteric angiogram showing portal vein occlusion and gastroesophageal varices (arrow) (same ... In the setting of portal hypertension, the presence of varices and the patency of the portal and splenic veins can be evaluated ...
Pylorus-Preserving Pancreaticoduodenectomy (PPPD): Background, Indications, Contraindications
The superior mesenteric vein (SMV), the portal vein (PV), and the SMV-PV confluence are all patent (with no thrombosis) ... The tumor can be evaluated in relation to important vascular structures. A fat plane should be seen between the low-density ... Sequential compression devices for deep venous thrombosis (DVT) prevention * Preoperative biliary decompression if delay to ... it is of varying size and is wedged between the superior mesenteric vessels (vein on the right, artery on the left) in front ...
Acute Mesenteric Ischemia: Practice Essentials, Anatomy, Pathophysiology
... is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischemia and eventual gangrene of ... The IMV joins the splenic vein, which then joins the SMV to form the portal vein. The portal vein enters the liver. ... Mesenteric venous air (red arrows) and free intraperitoneal air (white arrow.) Mesenteric venous air is common finding in ... Acute mesenteric arterial thrombosis. Causes of AMAT (thrombotic AMI) include the following:. * Atherosclerotic vascular ...
Carbon Dioxide Angiography: Overview, Techniques, Clinical Applications
... which demonstrated that CO2 use was safe and well tolerated with peripheral venous injections. ... gas was used as a contrast agent in the venous circulation in the 1950s and 1960s to delineate the right heart for evaluation ... and diminutive portal vein (PV). There is retrograde filling of the inferior mesenteric (IMV) and superior mesenteric (SMV) ... CO2 angiography may allow visualization of vascular renal cell carcinoma, as well as tumor invasion of the renal vein or ...
Portal Hypertension: Practice Essentials, Background, Anatomy
Two important factors-vascular resistance and blood flow-exist in the development of portal hypertension. ... Many conditions are associated with portal hypertension, with cirrhosis being the most common cause of this disorder. ... Normal venous flow through the portal and systemic circulation. IMC = inferior mesenteric vein; IVC = inferior vena cava; SVC ... The superior mesenteric vein and the splenic vein unite behind the neck of the pancreas to form the portal vein. The portal ...
Portal Hypertension Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography
Portal hypertension (PH) represents an increase of the hydrostatic pressure wi... ... In portal hypertension imaging, ultrasound techniques such as duplex ultrasonography or spectral Doppler imaging and color ... Venous-phase findings: splenic vein thrombosis, superior mesenteric vein thrombosis, portal vein thrombosis, collateral ... Vascular diseases and MR angiography of the liver. Magn Reson Imaging Clin N Am. 1997 May. 5(2):377-96. [QxMD MEDLINE Link]. ...
Abdominal Vascular Injuries: Background, Anatomy, Pathophysiology
Injuries to major abdominal vessels are uncommon but highly lethal vascular crises. Predictably, exsanguinating hemorrhage is ... phrenic artery/vein; lumbar artery/vein; gonadal artery/vein; ovarian artery/vein; other nonnamed small arterial or venous ... Portal. Hepatic (extrahepatic). * Grade I injury includes the following: No named superior mesenteric artery or superior ... mesenteric vein branches; nonnamed inferior mesenteric artery or inferior mesenteric vein branches; ...
Imaging of Liver Transplantation Complications: Practice Essentials, Complications, Postoperative Fluid Collections
Follow-up portography shows that the portal vein is open. Competing collaterals communicating with the superior mesenteric vein ... Aberrant hepatic venous and portal venous anatomy can increase the difficulty of performing LDLTXs compared with that of ... Post-transplant complications can be categorized into vascular, non-vascular and biliary. Ultrasonography (US), CT, MRI, ... Follow-up portography shows that the portal vein is open. Competing collaterals communicating with the superior mesenteric vein ...
Mesenteric Ischemia Imaging: Practice Essentials, Radiography, Computed Tomography
Mesenteric ischemia is characterized by inadequate blood flow to or from the involved mesenteric vessels supplying a particular ... causing venous congestion of the small bowel mesentery. This is likely secondary to thrombus in the portal vein (same patient ... AMI is a vascular emergency that will lead to death if left untreated. Although the disease is responsible for fewer than 1 in ... Large-vessel disease (superior mesenteric artery/vein [SMA/SMV]; inferior mesenteric artery/vein [IMA/IMV]) is diffuse, whereas ...
Portal Vein Obstruction: Background, Pathophysiology, Etiology
The vast majority of cases are due to primary thrombosis of the portal vein; most of the remaining cases are caused by ... portal vein obstruction was first reported in 1868 by Balfour and Stewart, who described a patient presenting with an enlarged ... The portal vein forms at the junction of the splenic vein and the superior mesenteric vein behind the pancreatic head, and it ... Idiopathic portal hypertension and extrahepatic portal venous obstruction. Hepatol Int. 2018 Feb. 12(Suppl 1):148-67. [QxMD ...
Conduits for Vascular Reconstruction in the Pediatric Patient: Practice Essentials, Types of Grafts, Hemodialysis Access in the...
Vascular reconstruction in pediatric patients requires a substantially different approach from that used in adults. Many ... Reconstruction of portal vein and superior mesenteric vein after extensive resection for pancreatic cancer. J Korean Surg Soc. ... American Venous Forum, Central Surgical Association, Midwest Vascular Society, Peripheral Vascular Surgery Society, Society for ... Native veins (eg, great saphenous vein [GSV], popliteal vein, internal iliac vein, umbilical vein) ...
Cirrhosis Imaging: Practice Essentials, Radiography, Computed Tomography
Superior mesenteric artery, venous-phase injection (same patient as in the previous image) opacifies the portal vein. A second ... Intrahepatic vascular changes in cirrhosis. In cirrhosis, the dynamics of the hepatic arterial and portal venous circulation ... Portal vein thrombosis. Portal vein thrombosis, shown below, can be diagnosed with relative confidence if a distended portal ... Superior mesenteric artery, venous-phase injection (same patient as in the previous image) opacifies the portal vein. A second ...
Portal Vein Thrombosis Imaging: Practice Essentials, Radiography, Computed Tomography
Reduced portal blood flow caused by hepatic parenchymal disease and abdominal sepsis (ie, infectious or ascending ... Portal vein thrombosis (PVT) is being recognized with increasing frequency with the use of ultrasonography. ... Portal vein thrombosis. Digital subtraction portal venous-phase superior mesenteric angiogram, obtained in the same patient as ... Portal vein thrombosis may be a complication of liver cirrhosis and may occur as a primary vascular disorder without liver ...
Lower Gastrointestinal Bleeding: Practice Essentials, Background, Anatomy
The superior mesenteric vein drains the right side of the colon, joining the splenic vein to form the portal vein. The inferior ... Also in 1965, Baum et al described selective mesenteric angiography, which permitted the identification of vascular ... low-grade colonic contraction that obstructs the mucosal venous drainage. Over time, mucosal capillaries dilate, become ... The inferior mesenteric vein carries blood from the left side of the colon to the splenic vein. A rich network of vessels from ...
Paroxysmal Nocturnal Hemoglobinuria: Practice Essentials, Pathophysiology, Etiology
... portal, mesenteric, splenic, and renal veins) and, most recently recognized, arterial thrombosis. ... NO plays a major role in vascular homeostasis and has been shown to be a critical regulator of basal and stress-mediated smooth ... Venous thrombosis usually manifests as a sudden catastrophic complication, with severe abdominal pain, a rapidly enlarging ... 22] Sixty patients died; of 48 patients whose cause of death was known, 28 died from venous thrombosis or hemorrhage. Thirty- ...
Ischemic Colitis Imaging: Practice Essentials, Radiography, Computed Tomography
In cases of superior or inferior mesenteric vein thrombosis, the veins may not be visualized, and collateral venous filling may ... Nonspecific signs of bowel ischemia, including bowel obstruction, mesenteric edema, mesenteric vascular engagement, and ascites ... Bowel Ischemia and Portal Venous Gas: What to Do?. J Laparoendosc Adv Surg Tech A. 2016 Sep. 26 (9):713-4. [QxMD MEDLINE Link] ... The venous phase of a superior or inferior mesenteric angiogram may depict small ectatic draining veins. [38] ...
Pancreatic Cancer Imaging: Practice Essentials, Radiography, Computed Tomography
Superior mesenteric vein encasement by tumor is seen in 23%, and the splenic vein is encased by tumor in 15%, with portal vein ... Portal venous involvement may be more apparent on sonography than on CT and/or MRI, and liver lesions can be characterized as ... Vascular encasement usually determines unresectability and is seen on CT as narrowing, displacement, or obliteration of the ... Complete occlusion of the splenic vein is seen in 34%, and complete occlusion of the superior mesenteric vein is seen in 10%. ...
Angiodysplasia of the Colon: Background, Pathophysiology, Etiology
Angiodysplasia is the most common vascular lesion of the gastrointestinal tract, and this condition may be asymptomatic, or it ... 9] Portal hypertension colopathy, a form of colonic angiodysplasia, has been described. [10] Vascular ectasia of the entire GI ... This accounts for the characteristic early-filling vein observed during mesenteric angiography. ... and increased intraluminal pressure can diminish venous flow lend further support to this theory. Dilated submucosal veins have ...
Vascular Lesion Embolization Imaging: Practice Essentials, Embolization Materials And Substances, Vascular Anomalies
... originating from the superior mesenteric artery) has been replaced and to demonstrate patency of the portal vein. Then, the ... 1] Venous malformations are the most common vascular malformation and are generally found in the head and neck area or in the ... Vascular Anomalies. Vascular anomalies are grouped into 2 categories: hemangiomas and vascular malformations. Vascular ... Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have?. Cardiovasc Intervent ...
Paroxysmal Nocturnal Hemoglobinuria: Practice Essentials, Pathophysiology, Etiology
... portal, mesenteric, splenic, and renal veins) and, most recently recognized, arterial thrombosis. ... NO plays a major role in vascular homeostasis and has been shown to be a critical regulator of basal and stress-mediated smooth ... Venous thrombosis usually manifests as a sudden catastrophic complication, with severe abdominal pain, a rapidly enlarging ... 22] Sixty patients died; of 48 patients whose cause of death was known, 28 died from venous thrombosis or hemorrhage. Thirty- ...
Antiphospholipid Syndrome and Pregnancy: Background, Pathophysiology, Etiology
... portal, splenic, subclavian and mesenteric veins). The aPL antibodies are detected in approximately 2% of all patients with ... The aPL antibodies account for 65-70% of cases of venous thrombosis in women with venous thrombosis in unusual sites (eg, ... and vascular cell adhesion molecule and of monocyte adhesion. ... Approximately 22% of women with APS have had venous thrombosis ... and venous thrombosis being reported in patients with this syndrome. Previous thrombosis in the face of a diagnosis of APS has ...
Pancreatic Cystic Neoplasm (PCN) Imaging: Practice Essentials, Radiography, Computed Tomography
... displacement of the portal venous branches and encasement of the junction of the superior mesenteric vein and the portal vein. ... When there is suspicion of malignacy or concomitant pancreatic cancer and when assessment of vascular involvement, peritoneal ... displacement of the portal venous branches and encasement of the junction of the superior mesenteric vein and the portal vein. ... Superior mesenteric angiograms show a hypervascular tumor. The tumor also derives its blood supply from the celiac axis (not ...