J Korean Radiol Soc.  2005 Feb;52(2):123-132. 10.3348/jkrs.2005.52.2.123.

Magnetic Resonance Imaging Findings of Portal Biliopathy

• Shin SM
• Kim S
• Lee JW
• Kim CW
• Jeong YJ
• Choo KS
• Lee TH
• Lee SH
• Kim GH
• Cho M

• KMID: 1945425
• DOI: http://doi.org/10.3348/jkrs.2005.52.2.123

Abstract

PURPOSE: We wanted to evaluate the MR imaging findings of portal biliopathy.
MATERIALS AND METHODS
We retrospectively reviewed the MR imaging of twelve patients having biliary abnormalities and portal cavernoma. Two radiologists working in consensus analyzed the presence of extrahepatic portal vein obstruction, cavernous transformation, portosystemic collaterals and bile ducts abnormalities that included irregular contour, stricture, ductal dilatation, wall thickening and enhancement of the ductal wall.
RESULTS
Extrahepatic portal vein obstruction was replaced by cavernous transformations in all patients. The cavernous transformations depicted on the MR scans were paracholedochal veins in 12 patients and epicholedochal veins in 6 patients. Three different types of biliary abnormalities were present: 1) the pseudocholangiocarcinoma type (3 patients) that resembled extrahepatic cholangiocarcinoma, 2) the varicoid type (6 patients) that was mainly distinguished by the multiple smooth extrinsic impressions along the common bile duct and 3) the mixed type (3 patients). The highly specific findings for the pseudocholangiocarcinoma type disease were thickening and delayed enhancement of the biliary ductal wall.
CONCLUSION
The MR findings of portal biliopathy include cavernous transformation of the portal vein and morphological alterations of the biliary tracts such as irregular contour, biliary stricture with proximal ductal dilatation and thickening of the ductal wall with delayed enhancement. Recognition of these MR findings should facilitate the accurate diagnosis of portal biliopathy and prevent the misinterpretation or inappropriate management of this disease as malignancy or sclerosing chloangitis.

Keyword

Bile duct, MR; Gallbladder, MR; Gallbladder, varices; Portal vein, MR; Portal vein, abnormalities; Portal vein, stenosis or obstruction

MeSH Terms

Bile Ducts
Biliary Tract
Cholangiocarcinoma
Common Bile Duct
Consensus
Constriction, Pathologic
Diagnosis
Dilatation
Humans
Magnetic Resonance Imaging*
Portal Vein
Retrospective Studies
Veins