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cavernous transformation

Cavernous transformation of the portal vein is a sequela of portal vein thrombosis and is the replacement of the normal single channel portal vein with numerous tortuous venous channels. For a discussion of demographics and presentation, please refer to the article on portal vein thrombosis. Ultrasound is able to identify a normal portal vein in almost all cases when present (97%), and therefore is a good first-order examination. Doppler examination can be carried out at the same time to evaluate for portal hypertension. Cavernous transformation appears as numerous tortuous vessels occupying the portal vein bed. Flow is generally hepatopetal and continuous with little if any respiratory or cardiac variation. CT Multiphase CT can confirm the diagnosis by demonstrating: numerous vascular structures in the region of the portal vein, which enhance during the portal venous phase, and not during the arterial phase (distinguishing it from an arteriovenous malformation) possible linear areas of calcification within the previously thrombosed portal vein indicating chronic venous thrombosis