Learning objectives
To highlight the key points of a diagnostic report,
which are important for vascular surgeons before and after portosystemic shunting.
Background
Portosystemic shunt is a safe effective treatment for patients with portal hypertension due to portal vein obstruction and cirrhosis.
The most common shunts are mesocaval and distal splenorenal shunt (Fig.1,
4).
Findings and procedure details
Nowadays the planning and patency of surgical portosystemic shunts is estimated on the CT in the late arterial,
portal,
venous phases and 3D reconstruction.
Before the surgery,
CT is used for predicting the type of surgery.
Radiologist have to report:
Diameter and patencyof portal,
splenic,
mesenteric,
renal vein (especially the entry of the left renal vein) (Fig.2).
Topography of the splenic vein - position relative to the pancreas,
distance to the left renal vein (Fig.3).
Patency of the inferior vena cava and absence of its...
Conclusion
The correct radiological report allows the vascular surgeon to predict the variant of the portosystemic shunts and assess the risks.
Personal information
Ekaterina B.
Guseva(A.K.
EramishantsevCity ClinicalHospital,
Department of Health Care of Moscow; Research and Practical Center of Medical Radiology,
Department of Health Care of Moscow) e-mail:
[email protected]
Dmitry V.
Burenchev (A.K.
EramishantsevCity ClinicalHospital,
Department of Health Care of Moscow; Research and Practical Center of Medical Radiology,
Department of Health Care of Moscow)
Sergey P.
Morozov (Research and Practical Center of Medical Radiology,
Department of Health Care of Moscow)
Natalya V.
Ledikhova (Research and Practical Center of Medical Radiology,
Department of Health Care of Moscow)
Garik V....
References
Bandali,
M.
F.
Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy / M.
F.
Bandali,
A.
Mirakhur,
E.
W.
Lee [et al.] // World J.
Gastroenterol.
- 2017.
- Vol.
23,
№ 10.
-P.
1735-1746.
doi: 10.3748/wjg.v23.i10.1735
Pillai,
A.
K.,
Andring,
B.,
Patel,
A.,
Trimmer,
C.,
& Kalva,
S.
P.
(2015).Portal hypertension: a review of portosystemic collateral pathways and endovascular interventions.
Clinical Radiology,
70(10),
1047–1059.doi:10.1016/j.crad.2015.06.077
Bloom,
S.,
Kemp,
W.,
& Lubel,
J.
(2015).Portal hypertension: pathophysiology,
diagnosis and management.
Internal Medicine Journal,
45(1),...