Portosystemic collateral circulation in the falciform ligament: evaluation with three dimensional dynamic contrast enhanced MR angiography in patients with portal hypertension
10.3760/cma.j.issn.1005-1201.2009.04.013
- VernacularTitle:门静脉高压镰状韧带内门体侧支循环在三维动态增强MR血管成像上的表现
- Author:
Zhuo WU
;
Biling LIANG
;
Yong LI
;
Rong ZHANG
;
Jinglian ZHONG
;
Ruixin YE
- Publication Type:Journal Article
- Keywords:
Magnetic resonance angiography;
Hypertension,portal;
Collateral circulation
- From:
Chinese Journal of Radiology
2009;43(4):386-389
- CountryChina
- Language:Chinese
-
Abstract:
Objective The purpose of our study was to investigate three dimensional dynamic contrast enhanced MR angiography(3D DCE M RA) in the detection of portosystemic collateral circulation in the falciform ligament in patients with portal hypertension. Methods From April 2003 to July 2008, 53 portal hypertension patients with varices in the falciform ligament were evaluated with 3D DCE MRA.Two radiologists independently assessed the number, diameter, location and drainages of the portosystemic collateral circulation in the falciform ligament according to the information on the 3D DCE MRA.Results The veins in the falciform ligament were classified into the superior and inferior groups, and both groups arise from the left trunk of the portal vein.In our study, the number of varices detected on 3D DCE MRA images varied from 1 to 3, and the diameters of these vessels varied from 0.4 to 2.6 cm.The inferior group consisted of paraumbilical/umbilical veins (47 cases), which flowed toward umbilicus and then drained upwards (n = 16) including deep superior epigastric veins (n = 7), superficial superior epigastric veins (n = 9), downwards (n = 40) including deep inferior epigastric veins (n = 7), superficial inferior epigastric veins (n = 33), or upwards and downwards at the same time (n = 9).The superior group of vessels in the falciform ligament were directly anastomosed with the internal thoracic vessels (n = 6).Conclusion In patients with portal hypertension, 3D DCE MRA can optimally demonstrate the portosystemic collateral circulation in the falciform ligament, which includes the superior and inferior drainage groups.