Magnetic Resonance Angiography and Color Doppler Ultrasound in Portosystemic Shunts

Abstract

Repeated or massive hemorrhage from gastroesophageal varices is a life-threatening complication of portal hypertension and requires appropriate therapy. The therapeutic concept in treatment of symptomatic portal hypertension includes portosystemic shunting. Since portosystemic shunts may thrombose, resulting in acute blockage and the life-threatening recurrence of symptoms, noninvasive methods for the evaluation of portosystemic shunt patency are important, especially when they are available in intensive care units. The patency of portosystemic shunts has usually been assessed by angiography. However, angiography is an invasive procedure, and the anatomically isolated portal system be difficult to opacify. In addition, angiography involves a certain risk to patients who are debilitated by chronic liver disease. New and noninvasive techniques to assess shunt patency include magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and color Doppler sonography (CDS).