Imaging of the Portal Vein

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 10, 2026:

Computed Tomography: 2.75
Procedures: 2.75
Abdomen and Pelvis: 2.75

Magnetic Resonance Imaging: 2.75
Procedures: 2.75
Body: 2.75

Registered Radiologist Assistant: 2.75
Procedures: 2.75
Abdominal Section: 0.50
Neurological, Vascular, and Lymphatic Sections: 2.25

Sonography: 2.75
Procedures: 2.75
Abdomen: 2.75

Vascular Sonography: 2.75
Procedures: 2.75
Abdominal/Pelvic Vasculature: 2.75

Outline

1. Introduction
2. Anatomy
   1. Intrahepatic Anatomy
      1. Rotation
      2. Variant Minor Tributaries
   2. Extrahepatic Anatomy
      1. Circumportal Pancreas
      2. Preduodenal PV
3. PV Thrombosis
   1. Acute PVT
   2. Hepatic Artery Buffer Response
   3. Pylephlebitis
   4. Chronic PVT
      1. Cavernous Transformation of the PV
      2. Liver Morphology
      3. Altered PV Appearance
   5. Tumor in Vein
4. Portal Hypertension
   1. Stigmata of PH
   2. Portosinusoidal Vascular Disorder
5. Shunts
   1. Portosystemic Shunts
      1. Intrahepatic Portosystemic Shunts
      2. Congenital Extrahepatic Portosystemic Shunts
   2. Anterioportal Shunts
6. PV Aneurysms
7. PV Gas
8. Conclusion

Objectives

Upon completion of this course, students will:

1. know the % of oxygen supplied to the liver by the portal vein
2. understand the importance of portal vein branching patterns knowledge for the success of hepatic interventions
3. know the structures of the classic anatomy of the portal vein
4. know the normal LPV orientation on axial images
5. know the aspects of a trifurcating PV formation
6. understand how an extrahepatic mass in the right upper quadrant will affect the liver and LPV positioning
7. be familiar with both the classical anatomy PV drainage and the aberrant PV drainage patterns
8. know the vessel(s) that contribute(s) to portal vein formation
9. know how aberrant pancreatic tissue may be misinterpreted when circumportal pancreas is identified
10. be familiar with congenital abnormalities that are associated with a preduodenal portal vein
11. know the causes of portal vein thrombosis
12. know the reason(s) why a CT should be performed once an acute PVT has been diagnosed
13. understand how PVT appears both sonographically and with contrast-enhanced ultrasound
14. know how portal vein thrombosis displays on contrast-enhanced CT
15. be familiar with the most dangerous manifestation(s) of portal vein thrombosis
16. know what THAD is in relation to CT imaging of the liver
17. be familiar with the causes of pylephlebitis
18. know the common imaging characteristics of portal vein thrombosis and thrombophlebitis of the portal vein or one of its tributaries
19. know the veins that are principally involved in the formation of the venous plexus of the common bile duct, which are often grossly dilatated in CTPV to fill the role of the portal vein
20. know what a chronic lack of portal blood supply causes in the affected liver segment
21. know the attributes that both TIV and bland thrombus demonstrate
22. understand the risk factors for portal vein thrombosis
23. know how contrast-enhanced ultrasound compares with CT for the diagnosis of tumor in vein
24. know the criteria that must be met for MR imaging to be 100% sensitive for tumor in vein
25. be familiar with the features of portal hypertension
26. be familiar with the histopathologic entities that comprise portosinusoidal vascular disorder (PSVD)
27. know what is observed in PSVD patients during the hepatobiliary phase of contrast-enhanced MR imaging
28. be familiar with the four types of intrahepatic portosystemic shunts
29. be familiar with the types of congenital extrahepatic portosystemic shunts
30. know how peripheral arterioportal shunts demonstrate on radiologic images
31. understand the data about the defined diameter limit of portal vein aneurysms
32. be familiar with benign causes of portal vein gas