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Rational classification of portal vein thrombosis and its clinical significance.

Ma J, Yan Z, Luo J, Liu Q, Wang J, Qiu S - PLoS ONE (2014)

Bottom Line: Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT) compared to those without SMVT (p<0.001).The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001).In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT.

View Article: PubMed Central - PubMed

Affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.

ABSTRACT
Portal vein thrombosis (PVT) is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension) and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women) with PVT were examined using contrast-enhanced computed tomography (CT). The percentage of vein occlusion, including portal vein (PV) and superior mesenteric vein (SMV), was measured on CT image. Of 60 patients, 17 (28.3%) met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT) compared to those without SMVT (p<0.001). However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001). Complications of portal hypertension were significantly associated with cirrhosis (p<0.001) rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study.

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Related in: MedlinePlus

Cirrhotic morphology in CT imaging.Portal venous phase CT scan shows nodularity on the liver surface and heterogeneity of the liver parenchyma. A ratio of transverse caudate lobe width (black arrow) to right lobe width (white arrow) is greater than 0.65. Splenomegaly was present.
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pone-0112501-g005: Cirrhotic morphology in CT imaging.Portal venous phase CT scan shows nodularity on the liver surface and heterogeneity of the liver parenchyma. A ratio of transverse caudate lobe width (black arrow) to right lobe width (white arrow) is greater than 0.65. Splenomegaly was present.

Mentions: In this study, cirrhosis was diagnosed from liver morphology in CT imaging (Fig 5). The cirrhosis was characterized by surface nodularity and heterogeneity of liver parenchyma. A ratio of transverse caudate lobe width to right lobe width greater than or equal to 0.65 was a positive indicator for the diagnosis of cirrhosis [19]. Splenomegaly was often found in patients with cirrhosis.


Rational classification of portal vein thrombosis and its clinical significance.

Ma J, Yan Z, Luo J, Liu Q, Wang J, Qiu S - PLoS ONE (2014)

Cirrhotic morphology in CT imaging.Portal venous phase CT scan shows nodularity on the liver surface and heterogeneity of the liver parenchyma. A ratio of transverse caudate lobe width (black arrow) to right lobe width (white arrow) is greater than 0.65. Splenomegaly was present.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231054&req=5

pone-0112501-g005: Cirrhotic morphology in CT imaging.Portal venous phase CT scan shows nodularity on the liver surface and heterogeneity of the liver parenchyma. A ratio of transverse caudate lobe width (black arrow) to right lobe width (white arrow) is greater than 0.65. Splenomegaly was present.
Mentions: In this study, cirrhosis was diagnosed from liver morphology in CT imaging (Fig 5). The cirrhosis was characterized by surface nodularity and heterogeneity of liver parenchyma. A ratio of transverse caudate lobe width to right lobe width greater than or equal to 0.65 was a positive indicator for the diagnosis of cirrhosis [19]. Splenomegaly was often found in patients with cirrhosis.

Bottom Line: Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT) compared to those without SMVT (p<0.001).The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001).In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT.

View Article: PubMed Central - PubMed

Affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.

ABSTRACT
Portal vein thrombosis (PVT) is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension) and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women) with PVT were examined using contrast-enhanced computed tomography (CT). The percentage of vein occlusion, including portal vein (PV) and superior mesenteric vein (SMV), was measured on CT image. Of 60 patients, 17 (28.3%) met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT) compared to those without SMVT (p<0.001). However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001). Complications of portal hypertension were significantly associated with cirrhosis (p<0.001) rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study.

Show MeSH
Related in: MedlinePlus