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RADIOLOGY: VASCULAR: Case# 32869: PORTAL VEIN THROMBOSIS, PC-MRI. 64 year old male with history of cirrhosis, jaundice, and anorexia. MRI is performed to assess portal venous flow. Cine Phase contrast MRI images show multiple collateral vessels within the perisplenic area with suggestion of a splenorenal shunt as well. There is thrombus in the distal splenic vein to the confluence with the SMV and thrombosis of the portal vein. The Superior mesenteric vein is patent to the splenic confluence. There is a small track of cephelad flow within the portal vein or immediately adjacent suggesting either incomplete thrombosis or early collateral development. A 3.5 x 3.5 cm round vascular structure is identified just inferior to the entrance of the left renal vein on the coronal angiographic sequence. This most likely represents collateral veins entering the IVC in this area. Anterior abdominal wall varices were also identified. The IVC and the abdominal aorta appear unremarkable. Cine Phase contrast MRI images show multiple collateral vessels within the perisplenic area with suggestion of a splenorenal shunt as well. There is thrombus in the distal splenic vein to the confluence with the SMV and thrombosis of the portal vein. The Superior mesenteric vein is patent to the splenic confluence. There is a small track of cephelad flow within the portal vein or immediately adjacent suggesting either incomplete thrombosis or early collateral development. A 3.5 x 3.5 cm round vascular structure is identified just inferior to the entrance of the left renal vein on the coronal angiographic sequence. This most likely represents collateral veins entering the IVC in this area. Anterior abdominal wall varices were also identified. The IVC and the abdominal aorta appear unremarkable.

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Peter Anderson
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