The portal venous system is responsible for the venous drainage of most of the gastrointestinal and biliary tracts, spleen and pancreas into to the liver and contributing for about 75% of its blood flow [1]. The main portal vein (MPV) results from the confluence of the superior mesenteric and splenic veins, posterior to the neck of the pancreas and embryologically, it is formed during the second month of gestation by selective involution of vitelline veins, which have multiple bridging anastomoses.[2] Alterations in the pattern of...

In this retrospective study, CT scans and portographies of 50 consecutive patients (23 women and 27 men, ages 41-81) submitted to PVE were evaluated for portal venous anatomy and its variants. Diagnosticagreement betweenCT and digital subtraction angiography (DSA) was calculated. All CT examinations were acquired on portal phase (60 seconds after intravenous contrast injection). Two independent radiologists (one interventional radiologist with 15 years of experience and one 4th-year radiology resident) performed the analysis. Disagreements were solved in consensus.

Readings from the two independent radiologists are summarized in Table 1. Of the 50 patients included in the study, 32 (64%) had normal portal vein anatomy on CT scan and 18 (36%) showed anatomic variants. Typically, the MPV divides into right and left branches in the hepatic hilum, with the right portal vein (RPV) subdividing into right anterior sectorial branch (RASB), supplying segments V and VIII, and right posterior sectorial branch (RPSB), supplying segments VI and VII. The left portal vein (LPV) supplies hepatic segments...

Portal vein variants are common and there is a high correlation agreement between direct portography and CT although suboptimal DSA technique might disrupt anatomical analysis. Pre-procedure CT is an accurate tool for anatomical mapping of the portal venous system and to guide and adapt its approach, minimizing the patient risk.

E. Coimbra; Lisbon/PT - nothing to disclose F. V. Veloso Gomes; Lisbon/PT - nothing to disclose R. Sousa; Ponta Delgada/PT - nothing to disclose J. H. M. Luz; Lisbon, LISBON/PT - nothing to disclose T. Bilhim; Lisbon/PT - nothing to disclose N. V. Costa; Lisbon/PT - nothing to disclose

Carneiro C. et al (2019). All about portal vein: a pictorial display to anatomy, variants and physiopathology. Insights into Imaging 10:38. Koç Z. et al (2007). Portal vein variations: clinical implications and frequencies in routine abdominal multidetector CT. Diagn Interv Radiol, vol 13, issue 2. Gallego C. et al (2002). Congenital and Acquired Anomalies of the Portal Venous System. RadioGraphics 22:141–159. Schmidt S. et al (2008). Portal Vein Normal Anatomy and Variants: Implication for Liver Surgery and Portal Vein Embolization. Seminars in interventional radiology, vol...