Imaging Findings And Preliminary Study Of Cavernous Transformation Of Portal Vein In Causes And Pathogenesis

Cavernous transformation of portal vein(CTPV) is a kind of disease that closely related to embolism in portal vein system,which caused 54%of CTPV.CTPV can cause a series of changes in portal vein system,biliary system and in hepar.In our study,CTPV was probed both in imaging findings and in its pathogenesis,and the study work was divided into 2 parts.1.To analyze the location characteristics of embolism in portal vein system and to probe the pathogenesis of this disease.Methods 267cases of embolism in portal vein system were collected and all the patients were given at least one of the following examination:ultrasound,MRI,DSA,and all were given plain and enhanced scanning of multi-spiral CT.Of all the patients,242cases of malignant tumor were proved by operation or biopsy,25 cases had no tumor.The involved condition of both upper mesenteric vein and splenic vein were compared,and the difference involved scale of the embolism in portal vein system was detected.Results①Upper mesenteric vein(145/267,79.2%) was more likely to be involved than splenic vein(17/267,6.4%) in embolism of portal vein system(P＜0.05).②The total number of the involved vein section in portal vein system of this disease were obviously high in non-tumor group than in malignant tumor group.Conclusion Functional,anatomical and blood dynamic characteristics of the mesenteric vein was greatly related to the embolism of portal vein system;The embolism scale caused by non-tumor diseases was wider than that caused by malignant tumor.2.To analyze the radiological characteristics and to explore the pathogenesis of CTPV.Methods:38 cases of CTPV which were clinical proved were analyzed retrospectively.All the patients were divided into malignant tumor group and non-tumor group,and all underwent at least two of the following examination:ultrasound,MRI,DSA,and CT.The image findings were concluded and conditions of superior mesenteric and splenic vein were evaluated.All data was analyzed statistically.Results:①The normal portal vein was not shown in all cases,with multi-vessels in the according areas.Vessels around bladder and the lesser gastric curvature appeared in some cases;along the some embolic branches of the portal vein,branches of proper hepatic artery were found somewhat dilated.②Transient enhancement in late arterial period appeared both in malignant tumor group(3cases)and in non-tumor group(5 cases);hypo-trophy and hypertrophy complex could be found only in 1 case in non-tumor group;③Upper mesenteric vein(18/38,47.4%) was more likely to be involved than splenic vein(6/38,15.8%,P＜0.05).Conclusion CTPV was a slow compensation to CTPV,which could cause series of changed in hepar, biliary and vessel system,and the changes could be different due to the different causes.Involved vessels of CTPV had the same regularity with embolism of portal vein system,suggesting the relation of their pathogenesis.