Subject(s)
Budd-Chiari Syndrome/etiology , Catheterization, Central Venous/adverse effects , Catheters, Indwelling/adverse effects , Vena Cava, Inferior , Acute Disease , Budd-Chiari Syndrome/diagnostic imaging , Budd-Chiari Syndrome/surgery , Catheterization, Central Venous/instrumentation , Child, Preschool , Fatal Outcome , Female , Humans , Intraoperative Complications , Liver Failure/etiology , Parenteral Nutrition/adverse effects , Parenteral Nutrition/methods , Phlebography , Thrombectomy/adverse effects , Thrombectomy/methods , UltrasonographyABSTRACT
Evaluation of the portal venous system is required in several clinical circumstances, including before and after liver transplantation, before creation of a transjugular intrahepatic portosystemic shunt, in the clinical setting of bowel ischemia, or to evaluate varices. Several noninvasive modalities (magnetic resonance [MR] imaging and MR angiography, computed tomography [CT], and ultrasound [US]) are available for evaluation of the portal venous system in addition to the invasive angiographic methods. In most clinical circumstances, either CT or MR imaging and MR angiography in combination with US of the liver vasculature will allow complete evaluation of the portal venous system. Invasive evaluation of the portal venous system is necessary when results of the noninvasive tests disagree or are inconclusive. Angiography may also be indicated whenever noninvasive tests indicate occlusion of the portal venous system, as this is often a crucial clinical question and false-positive results can occur with the noninvasive tests.
Subject(s)
Diagnostic Imaging/methods , Portal Vein , Hepatic Veins/diagnostic imaging , Humans , Hypertension, Portal/diagnosis , Hypertension, Portal/etiology , Magnetic Resonance Angiography/methods , Magnetic Resonance Imaging/methods , Phlebography/methods , Portal Vein/diagnostic imaging , Portal Vein/pathology , Tomography, X-Ray Computed/methods , Ultrasonography, Doppler/methodsABSTRACT
In 1958 Jacques Caroli described communicating cavernous ectasia of the biliary tree as an uncommon cause of chronic, often life-threatening hepatobiliary disease. The disease now most often referred to as Caroli's disease is a rare condition characterized by nonobstructive saccular or fusiform dilatation of the intrahepatic bile ducts. In the so-called pure form, dilatation is classically segmental and saccular and is associated with stone formation and recurrent bacterial cholangitis. In the form associated with congenital hepatic fibrosis, bile duct dilatation usually is less prominent; portal hypertension and eventual liver failure typically develop as a result of the hepatic fibrosis. Caroli's disease usually is manifested in childhood and is thought to be congenital and probably inherited. Associated conditions include renal cystic disease, choledochal cysts, and cholangiocarcinoma. This pictorial essay illustrates the broad spectrum of imaging findings in Caroli's disease.
