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Congress: ECR25
Poster Number: C-12150
Type: Poster: EPOS Radiologist (educational)
Authorblock: F. Perotti, I. Ambrosini, O. Perrone, R. Cioni, L. Crocetti, E. Neri; Pisa/IT
Disclosures:
Francesca Perotti: Nothing to disclose
Ilaria Ambrosini: Nothing to disclose
Orsola Perrone: Nothing to disclose
Roberto Cioni: Nothing to disclose
Laura Crocetti: Nothing to disclose
Emanuele Neri: Nothing to disclose
Keywords: Veins / Vena cava, Catheter venography, CT-Angiography, Ultrasound-Colour Doppler, Venous access, Aneurysms
Learning objectives To review the role of interventional radiology in diagnosing and managing portal vein aneurysms (PVA) and their complications, highlighting imaging techniques and therapeutic options.
Read more Background Portal vein aneurysm (PVA) is a vascular anomaly characterized by a focal, fusiform, or saccular dilation of the portal vein, defined as a diameter greater than 1.5 cm in normal livers and 1.9 cm in cirrhotic patients. [1,2]PVA is a rare condition, with approximately 200 cases reported in the literature. Although PVAs account for less than 3% of all visceral aneurysms, they represent the most common type of visceral venous aneurysm. The most frequent sites are extrahepatic, with the common...
Read more Findings and procedure details Imaging modalitiesDoppler Ultrasound (US) is the first-line modality for diagnosing and monitoring PVA due to its non-invasive nature and accessibility. It evaluates aneurysm size and morphology, blood flow characteristics, and thrombus formation.  Gray-scale US: PVA appears as an anechoic structure continuous with the portal vein system. [4,5] Color Doppler: may reveal a characteristic “yin-yang” sign, indicating turbulent flow. Spectral Doppler: confirms a monophasic, non-pulsatile venous flow pattern. [2,4] Thrombosed PVA: exhibits variable echogenicity, mimicking solid masses, and typically appears hyperechoic without intraluminal flow on...
Read more Conclusion PVA is a rare vascular condition with no established management guidelines, due to the limited reported cases and variable clinical presentations. Therefore, a multidisciplinary approach in specialized hepatic centers is essential to tailor interventions based on disease severity and patient-specific factors. Interventional radiology plays a key role in diagnosis, risk stratification, treatment, and follow-up, offering a safe and effective alternative to surgery, particularly in high-risk patients. Advancements in imaging and endovascular techniques will contribute to standardized treatment protocols, ultimately improving clinical...
Read more References Laurenzi A, Ettorre GM, Lionetti R, Meniconi RL, Colasanti M, Vennarecci G. Portal vein aneurysm: What to know. Dig Liver Dis. 2015 Nov;47(11):918-23. doi: 10.1016/j.dld.2015.06.003. Epub 2015 Jun 19. PMID: 26188840. Kurtcehajic A, Zerem E, Alibegovic E, Kunosic S, Hujdurovic A, Fejzic JA. Portal vein aneurysm-etiology, multimodal imaging and current management. World J Clin Cases. 2023 Feb 6;11(4):725-737. doi: 10.12998/wjcc.v11.i4.725. PMID: 36818612; PMCID: PMC9928716. Majeed N, Bannan B, Ahmad N, Zia Z, Ashour M. Portal vein aneurysm, a pathological entity or an...
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