Multidetector CT venography and contrast-enhanced MR venography of the inferior mesenteric vein in paediatric extrahepatic portal vein obstruction

Pediatr Radiol. 2011 Mar;41(3):322-6. doi: 10.1007/s00247-010-1833-1. Epub 2010 Oct 15.

Abstract

Background: Extrahepatic portal vein obstruction (EHPVO) is a common cause of paediatric portal hypertension and the only permanent treatment is shunt surgery. The inferior mesenteric vein (IMV) is a portal venous channel that can be used for the shunt when the splenic vein/superior mesenteric vein is thrombosed or when a lienorenal shunt is not possible.

Objective: To compare MDCT venography (MDCTV) and contrast-enhanced MR venography (CEMRV) for visualisation of the IMV in children with EHPVO.

Materials and methods: This was a prospective study of 26 children (4-12 years, median 10 years) who underwent MDCTV and CEMRV. The IMV visualisation was graded using 4- and 2-point scales and the difference in visualisation was assessed by calculating the exact significance probability (P).

Results: The IMV was visualised in all children on MDCTV and 25/26 children on CEMRV (96%). The images were diagnostic in 23/26 children (88%) on MDCTV and in 18/26 (69%) children on CEMRV (P=0.063).

Conclusion: MDCTV and CEMRV are comparable for IMV visualisation with a tendency toward MDCTV being superior.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Child, Preschool
  • Constriction, Pathologic
  • Contrast Media
  • Female
  • Humans
  • Hypertension, Portal / diagnostic imaging*
  • Magnetic Resonance Imaging, Interventional*
  • Male
  • Mesenteric Veins / diagnostic imaging*
  • Mesenteric Veins / pathology*
  • Phlebography
  • Portal Vein / diagnostic imaging*
  • Portal Vein / pathology*
  • Tomography, X-Ray Computed*
  • Vascular Diseases / diagnosis*
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / pathology

Substances

  • Contrast Media