Francesco Alessandrino1, Corinne Strickland2, Amirkasra Mojtahed3, Steven C Eberhardt3, Koenraad J Mortele4. 1. Division of Abdominal Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States. Electronic address: pragia@hotmail.com. 2. Division of Abdominal Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States; Department of Radiology, University of New Mexico Hospital, Albuquerque, United States. 3. Department of Radiology, University of New Mexico Hospital, Albuquerque, United States. 4. Division of Abdominal Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.
Abstract
PURPOSE: To evaluate clinical and imaging features of pancreatic pseudocyst-portal vein fistula (PPVF). METHODS: Patients with evidence of PPVF on CT/MRI were included. Clinical presentation, outcomes, imaging appearance of the portal vein were recorded. RESULTS: 75% of patients developed portal hypertension, 62% cavernous transformation of the portal vein and 25% portal biliopathy. PPVF presented on CT as fluid-attenuated portal vein, and on MRI as T2-weighted hyperintense fluid-filled portal vein. PPVF was misdiagnosed as portal vein thrombosis in all patients who underwent CT as initial examination. CONCLUSIONS: Whenever PPVF is suspected on CT, MRI can be helpful to achieve accurate diagnosis and avoid unnecessary interventions.
PURPOSE: To evaluate clinical and imaging features of pancreatic pseudocyst-portal vein fistula (PPVF). METHODS:Patients with evidence of PPVF on CT/MRI were included. Clinical presentation, outcomes, imaging appearance of the portal vein were recorded. RESULTS: 75% of patients developed portal hypertension, 62% cavernous transformation of the portal vein and 25% portal biliopathy. PPVF presented on CT as fluid-attenuated portal vein, and on MRI as T2-weighted hyperintense fluid-filled portal vein. PPVF was misdiagnosed as portal vein thrombosis in all patients who underwent CT as initial examination. CONCLUSIONS: Whenever PPVF is suspected on CT, MRI can be helpful to achieve accurate diagnosis and avoid unnecessary interventions.