2007, Number 2
<< Back Next >>
Anales de Radiología México 2007; 6 (2)
Diagnóstico incidental de trombosis abdominopélvica por Tomografía Computarizada de multidetectores (TCMD)
Motta-Ramírez GA, González-Burgos O, Quiroz CO
Language: Spanish
References: 25
Page: 97-112
PDF size: 733.32 Kb.
ABSTRACT
Introduction: Venous thrombosis is a pathology of difficult or misleading clinical diagnosis, for that in approximately 70-80% of the patients that suffer from said illness; its existence is not suspected. The radiologist is usually the first doctor that suggests the thrombosis diagnosis in any topography based on the imaging findings and to the capacity of MDCT
Objective: To know the incidence and to demonstrate the characteristics through MDCT of venous thrombotic lesions.
Material and methods: A prospective study of February 2005 to August 2007 was carried out, of those cases remitted to MDCT for several reasons, including abdominal pain of origin to be determined, patients with cancer background and handling pursuit as well as post-surgery status and in those that incidentally, abdominopelvic venous thrombosis was demonstrated. 3,500 studies carried out with 8 and 16 MDCT equipment were included, with abdominopelvic conventional protocol that included simple initial and post-contrast IV, stages, as well as arterial, venous and excreting stages with sagital/coronary PMR.
Results: 76 patients -2% of the total of studies carried out in the study - (37 male, 39 female, age ranges 15 to 96 years) were identified, to those a study was carried out according to protocol for the following clinical conditions (67%); abdominal pain of origin to determine in 11 (20%), patients with cancer background and handling pursuit in 24 (44%), by search of primary in six (11%), post-surgical status in seven (13%), with hepatopathy in study in six (11%) and in those that incidentally abdominopelvic venous thrombosis was demonspost-surgery status and in those that incidentally, abdominopelvic venous thrombosis was demonstrated. 3,500 studies carried out with 8 and 16 MDCT equipment were included, with abdominopelvic conventional protocol that included simple initial and post-contrast IV, stages, as well as arterial, venous and excreting stages with sagital/coronary PMR.
Conclusions: Triphasic MDCT is the elected study for the identification and valuation of thrombosis of any topography and of the pathology that originates it, overcoming the evaluation carried out by US Doppler in the diagnosis of thrombosis, when specifying the location and extension of the thrombus. The timely diagnosis of thrombosis and of its etiology, justifies the employment of further radiation doses thoroughly for a thriphasic tudy.
REFERENCES
Marn CH, Francis IR. CT of portal venous occlusion. AJR 1992; 159: 717-26.
Ito K, Higuchi M, Kada T, et al. CT of acquired abnormalities of the portal venous system. Radiographics 1997; 17: 897-917.
Sze DY, O’Sullivan GJ, Johnson DL, et al. Mesenteric and portal venous thrombosis treated by transjugular mechanical thrombolisis. AJR 2000; 175: 732-4.
Jacoby WT, Cohan RH, Baker ME. Ovarian vein thrombosis in oncology patients: CT detection and clinical significance. AJR 1990; 155: 291-4.
Kreft B, Strunk H, Flacke S, et al. Detection of thrombosis in the portal venous system: Comparison of contrast-enhanced MRA with intraarterial subtraction angiography. Radiology 2000; 216: 86-92.
Warshauer DM, Lee JKT, Mauro MA. Superior mesenteric vein thrombosis with radiologically occult cause: A retrospective study of 43 cases. AJR 2001; 177: 837-41.
Parvey HR, Raval B, Sandler CM. Portal vein thrombosis: Imaging findings. AJR 1994; 162: 77-81.
Novick SL, Fishman EK. Portal vein thrombosis: Spectrum of HCT and CT radiographic findings. Abdom Imaging 1998; 23: 505-10.
Tublin ME, Dodd III GD, Baron RL. Benign and malignant portal vein thrombosis: Differentiation by CT characteristics. AJR 1997; 168: 719-23.
Mori H, Hayashi K, Uetani M, et al. High attenuation recent thrombus of the portal vein: CT demonstration and clinical significance. Radiology 1987; 163: 353-6.
Song B, Pengqui M, Oudkerk M, et al. Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: Spiral CT visualization of the collateral vessels. Abdom Imaging 2000; 25: 385-93.
Gallego C, Velasco M, Marcuello P, et al. Congenital and acquired anomalies of the portal venous system. Radiographics 2002; 22: 141-59.
Yu CW, Lee WJ, Tsai YH, et al. Demonstration of extensive mesenteric venous thrombosis and intestinal infarction with MDCT: Value of curved planar reformations. Abdom Imaging 2003; 28: 775-7.
Kumar S, Sarr MG, Kamath PS. Mesenteric venous thrombosis. NEJM 2001; 345: 1683-8.
Didier D, Racle A, Etievent JP, et al. Tumor thrombus of the inferior vena cava secondary to malignant abdominal neoplasm: US and CT evaluation. Radiology 1987; 162: 83-9.
Balthazar E, Gollapudi P. Septic thromboflebitis of the mesenteric and portal veins: CT imaging. JCAT 2000: 24: 755-60.
Gladish GW, Choe DH, Marom EM, et al. Incidental pulmonary emboli in oncology patients: Prevalence, CT evaluation, and natural history. Radiology 2006; 240: 246-55.
Chung JW, Yoon CJ, Jung SI. Acute iliofemoral deep vein thrombosis: Evaluation of underlying anatomic abnormalities by Spiral CT venography. JVIR 2004; 15: 249-56.
Lee AYY. Deep vein thrombosis and Cancer: Survival, recurrence and anticoagulant choices. Dis Mon 2005; 51: 150-7.
Sheen CL, Lamparelli H, Milne A. Clinical features, diagnosis and outcome of acute portal vein thrombosis. Q J Med 2000; 93: 531-4.
Cronin CG, Lohan DG, Keane M, et al. Prevalence and significance of asymptomatic venous thromboembolic disease found on oncologic staging CT. AJR 2007; 189: 162-70.
Simons GR, Piwnica-Worns DR, Goldhaber SZ. Ovarian vein thrombosis. Am Heart J 1993; 126: 641-7.
Jain KA, Jeffrey RB. Gonadal vein thrombosis in pts. with acute gastrointestinal inflammation: Diagnosis with CT. Radiology 1991; 180: 111-3.
Quane LK, Kidney DD, Cohen AJ. Unusual causes of ovarian vein thrombosis as revealed by CT and Sonography. AJR 1998; 171: 847-90.
Bradbury MS, Kavanagh PV, Chen MY, et al. Noninvasive assessment of portomesenteric venous thrombosis: Current concepts and imaging strategies. JCAT 2002; 26: 392-404.