Portal cholangiopathy: radiological classification and natural history.

Szczegóły
Abstrakt

Tytuł:: Portal cholangiopathy: radiological classification and natural history.
Autorzy:: Llop E; Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Barcelona 08036, Spain.
de Juan C
Seijo S
García-Criado A
Abraldes JG
Bosch J
García-Pagán JC
Źródło:: Gut [Gut] 2011 Jun; Vol. 60 (6), pp. 853-60. Date of Electronic Publication: 2011 Jan 26.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: London, British Medical Assn.
MeSH Terms:: Biliary Tract Diseases/*diagnosis
Portal Vein/*pathology
Venous Thrombosis/*complications
Acute Disease ; Adult ; Aged ; Algorithms ; Biliary Tract Diseases/classification ; Biliary Tract Diseases/etiology ; Biliary Tract Diseases/therapy ; Cholestasis/classification ; Cholestasis/diagnosis ; Cholestasis/etiology ; Chronic Disease ; Disease Progression ; Female ; Humans ; Magnetic Resonance Angiography/methods ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Young Adult
Entry Date(s):: Date Created: 20110129 Date Completed: 20110714 Latest Revision: 20220311
Update Code:: 20240104
DOI:: 10.1136/gut.2010.230201
PMID:: 21270119
: Czasopismo naukowe

Background/aim: Portal cholangiopathy (PC) is identified in over 80% of patients with portal vein thrombosis (PVT), but the true impact of this condition is not well known. This study investigated the relationship between cholangiographic abnormalities and clinical symptoms and their evolution over time.
Patients/methods: 67 consecutive patients with non-tumoral non-cirrhotic PVT following a standardised diagnostic protocol were studied. Findings at magnetic resonance angiography and cholangiography (MRA/MRC) were classified as no PC, grade I PC (minimal irregularities), grade II PC (stenosis without dilation) and grade III PC (stenosis with dilation). These changes were related to the presence of symptoms.
Results: 22 patients were diagnosed with acute PVT and 45 presented with chronic PVT. Overall, 52 patients had PC (6 grade I, 12 grade II and 34 grade III). 14 patients developed symptoms, all of whom had grade III PC. 30% of patients with acute PVT developed grade III PC within 1 year. In those without grade III PC, follow-up MRC showed no progression of the biliary lesions to grade III. The 5-year probability of developing symptoms of PC after acute PVT was 19%. In 45 patients with chronic PVT, MRA/MRC showed grade III PC in 26. In those without grade III PC, no progression of PC was observed at further follow-up MRC. The prevalence of symptoms of PC in these patients was 22%.
Conclusions: PC is a frequent complication that develops and stabilises early after PVT and becomes symptomatic in its more severe form (grade III). These data suggest that follow-up MRA/MRC is not mandatory and strategies to prevent the development of symptoms of PC should be tested in patients with grade III PC.

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