Abstract
Objective To evaluate the accuracy of 3D contrast-enhanced MR portography (3D CE MRP) by correlating with direct X-ray portography. Methods Twenty-six patients underwent 3D CE MRP study. The findings of 3D CE MRP including the patency of the portal vein and its intrahepatic left and right branches, as well as collaterals were evaluated and compared with those from direct x-ray portography. Causes of disagreement between the two methods were analyzed. Results The main portal vein appearance was accordant with 3D CE MRP and direct x-ray portography in all cases. For intrahepatic portal veins, the results agreed in 21 patients but disagreed in 5. In one patient with a huge tumor in right liver, the right posterior portal vein was classified as occluded at 3D CE MRP, but displaced and diffusely narrowed at direct x-ray portography. The findings of left intrahepatic portal vein were discordant in three patients with hepatocelluar carcinoma in the left lobe. 3D CE MRP demonstrated complete occlusion of the left portal veins, whereas direct x-ray portography showed proximal narrowing and distal occlusion. In another patient with hepatocelluar carcinoma, a small non-occlusive thrombus involving the sagittal segment of the left portal vein was seen on MRP but not on direct x-ray portography. With demonstration of portosystemic collaterals, 3D CE MRP showed results similar to those of X-ray portography, except one recanalized para-umbilical vein was excluded from the limited scan coverage. Conclusion 3D CE MRP correlated well with direct x-ray portography in most cases. Compared with direct portography, 3D CE MRP had limitation in distinguishing narrowing of an intrahepatic portal vein from occlusion. But it showed advantage in demonstrating small thrombus within portal vein.
Published Version
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