CT virtual endoscopy for analyzing variations in the hepatic portal vein.

Abstract

To evaluate the value of CT virtual endoscopy (CTVE) for accurately distinguishing varying types of portal veins (PVs). From 526 consecutive patients whose hepatic portal vein was well visualized, patients who were considered to have trifurcation of the main portal vein (MPV) or right portal vein (RPV) on volume rendering (VR) and maximum intensity projection (MIP) imaging were chosen for the analysis. Two radiologists evaluated the PV anatomy of these patients and re-classified the types of PV variation using the CTVE technique. The Wilcoxon rank sum test was used to calculate differences in age between males and females. Thirty-two patients (20 males, 12 females; age range 21-68 years; mean age 43 years) were considered to have trifurcation of the MPV (15) or RPV (17) on VR and MIP imaging. Fifteen patients in total had a trifurcation confirmed by CTVE (6 patients were proven to have an MPV trifurcation by CTVE, and 9 were confirmed to have a RPV trifurcation). CTVE can differentiate PV variations that cannot be identified accurately on MIP and VR.