Portal vein calcification
Portal vein calcification is a rare radiologic finding which can be seen in long-standing portal venous hypertension.
Calcium may be deposited in a thrombus or in the wall of the portal vein and is more rarely found in the splenic vein and superior mesenteric vein.
One of the proposed mechanisms includes mechanical stress leading to sclerosis and calcification within the thickened intima and media of the vein.
Calcifications in the portal veins can be of clinical significance as they may be a sign of radiographically occult portal vein thrombosis, which is then discovered during surgery. Transjugular intrahepatic portosystemic stent shunting may also be difficult to perform in these patients 1.
Portal vein calcification carries a strong association with long-standing portal venous hypertension regardless of the underlying aetiology and a less stronger association with cirrhosis. It can rarely be associated with other entities such as hepatocellular carcinoma 1, 2.
It can be occasionally discovered on plain abdominal radiographs or is better demonstrated on CT scan, which can also show concurrent splenic vein and superior mesenteric vein calcification 1.
History and etymology
It was thought to be first described by Moberg in 1943 on a radiograph.
- 1. Wang CE, Sun CJ, Huang S et-al. Extensive calcifications in portal venous system in a patient with hepatocarcinoma. World J. Gastroenterol.20 (43): 16377-80. Free text at pubmed - Pubmed citation
- 2. Ayuso C, Luburich P, Vilana R et-al. Calcifications in the portal venous system: comparison of plain films, sonography, and CT. AJR Am J Roentgenol. 1992;159 (2): 321-3. doi:10.2214/ajr.159.2.1632347 - Pubmed citation
- 3. Freund M, Heller M. Portal venous calcifications 20 years after portosystemic shunting: demonstration by spiral CT with CT angiography and 3D reconstructions. Eur J Radiol. 2001;36 (3): 165-9. Pubmed citation
- 4. Verma V, Cronin DC, Dachman AH. Portal and mesenteric venous calcification in patients with advanced cirrhosis. AJR Am J Roentgenol. 2001;176 (2): 489-92. doi:10.2214/ajr.176.2.1760489 - Pubmed citation
- 5. Kawasaki T, Kambayashi J, Sakon M, Shiba E, Yokota M, Doki Y, Suehisa E, Nishimura K, Amino N, Miyai K. Portal vein calcification: a clinical review of the last 50 years and report of a case associated with dysplasminogenemia. Surgery today. 23 (2): 176-81. Pubmed