Portal hypertension evaluated by MR imaging

Thirteen patients with portal hypertension were examined by magnetic resonance (MR) imaging, using spin-echo sequences, and by visceral angiography. Data from this group were compared with the MR images and angiograms of 20 patients without portal hypertension. MR imaging demonstrated two of three cases of portal vein occlusion and four of five cases of occlusion of the retropancreatic portion of the superior mesenteric vein. Two thirds of the patients with portal hypertension and patent portal veins had marked MR signal within the main portal vein on MR images. Little or no signal was present in the portal veins of the 20 patients without portal hypertension. Our experience indicates that marked intraportal MR signal can be seen in patients with portal hypertension with or without venous occlusion. In some cases the size and distribution of venous collaterals allow one to distinguish between venous occlusion and other causes of portal hypertension. MR images confirmed the patency of distal splenorenal shunts in two patients studied.