Correlation between Primary Myelofibrosis and the Association of Portal Thrombosis with Portal-Biliary Cavernoma: US, MDCT and MRI Features

Abstract Objective Myelofibrosis is a rare chronic myelolymphoproliferative disease and is associated with increased risk of venous thromboembolism. The objective of this study is to retrospectively evaluate patients with primary myelofibrosis who underwent abdominal US, MDCT and MRI, in order to identify the development of portal thrombosis and its correlation with portal-biliary cavernoma. Methods We evaluated 125 patients with initial diagnosis of primary myelofibrosis and nonspecific abdominal pain who had undergone US with color Doppler. In 13 patients (8 men, 5 females; age: 45–85), US detected portal thrombosis with associated portal-biliary cavernoma. All patients subsequently underwent contrast-enhanced MDCT and MRI and 4 patients MR-cholangiography. The correlation between primary myelofibrosis and portal thrombosis and cavernoma respectively was calculated using χ2 test. Results About 10% of patients with primary myelofibrosis preliminary evaluated with US had partial (8 pts) or complete (5 pts) portal thrombosis associated with portal-biliary cavernoma with a χ2 = 0. In all patients, US detected a concentric thickening of main bile duct (MBD) wall (mean value: 7 mm); color Doppler always showed dilated venous vessels within the thickened wall of the biliary tract. Contrast-enhanced CT and MRI confirmed thickening of MBD walls with their progressive enhancement and allowed better assessment of the extent of the portal system thrombosis. MR-cholangiography showed a thin appearance of the MBD lumen with evidence of ab extrinsic compression. Conclusions The evidence of portal thrombosis and portal-biliary cavernoma in 10% of the patients with primary myelofibrosis indicates a close correlation between the two diseases. In the detection of portal thrombosis and portal-biliary cavernoma, US with color Doppler is the most reliable and economical diagnostic technique while contrast-enhanced MDCT and MRI allow better assessment of the extent of the portal vein thrombosis and of the complications of myelofibrosis.

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Comparison and correlation of CT scan and MRI for focal liver lesion detection and characterization

MedPulse International Journal of Radiology ◽

10.26611/10131227 ◽

2021 ◽

Vol 12 (2) ◽

pp. 81-84

Author(s):

M T Makada ◽

Keyword(s):

Ct Scan ◽

Clinical Symptoms ◽

Color Doppler ◽

Lesion Detection ◽

Benign Lesions ◽

Female Ratio ◽

Standard Format ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Background: Liver diseases create diagnostic challenge for attending clinicians. Role of radiological imaging, particularly newer modalities like Ultrasound, Color Doppler, CT scan, MRI, DSA, are highly reliable. Early identification of liver lesions provides the opportunity for the success of therapeutic approach. Contrast enhanced CT scan and contrast enhanced MRI are most advanced and appropriate modalities to detect and characterize liver focal lesions. In present study we tried to compare and correlate findings of both modalities. Methodology: We evaluated 40 cases of liver pathologies which are suspected in sonography examination. All patients were undergone contrast enhanced CT scan as well as MRI evaluation. Various radiological findings are recorded in standard format. Result: In total 40 patients of focal liver pathology all age groups are included. Male: female ratio is 70:30.Patients are presented with various clinical symptoms like right hypochondriac pain, fever, lump, jaundice, weight loss etc. Benign lesions are found in 40% of cases and malignant lesions are found in 60 % of cases. Most common pathology is liver metastatic lesions which are picked up by MRI with 100% accuracy. CT is able to characterize only 10 out of 13 metastatic cases(77%). Few other cases of benign lesions like hemangioma, hamartoam ,adenoma and FNH are also remained indeterminate in CT scan which all are accurately diagnosed and characterized by MRI and confirmed in histopathology. A case of HCC, lymphoma and nodular dysplasia also remained indeterminate in CT scan and further diagnosed and characterized by MRI.

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