Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2017; 23(10): 1735-1746
Published online Mar 14, 2017. doi: 10.3748/wjg.v23.i10.1735
Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy
Murad Feroz Bandali, Anirudh Mirakhur, Edward Wolfgang Lee, Mollie Clarke Ferris, David James Sadler, Robin Ritchie Gray, Jason Kam Wong
Murad Feroz Bandali, Anirudh Mirakhur, Mollie Clarke Ferris, David James Sadler, Robin Ritchie Gray, Jason Kam Wong, Department of Radiology, Foothills Medical Centre, University of Calgary, Calgary, Alberta T2N 2T9, Canada
Anirudh Mirakhur, Edward Wolfgang Lee, Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, Los Angeles, CA 90095, United States
Author contributions: All authors contributed to this review article with conception, literature review and analysis, image preparation and editing, manuscript drafting and critical revision and editing, and approval of the final version; Bandali MF and Mirakhur A contributed equally and are trainees of Lee EW.
Conflict-of-interest statement: Authors declare no potential conflicts of interests. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Edward Wolfgang Lee, MD, PhD, Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, 757 Westwood Plaza, Suite 2125, Los Angeles, CA 90095, United States. edwardlee@mednet.ucla.edu
Telephone: +1-310-2678771 Fax: +1-310-2673631
Received: November 14, 2016
Peer-review started: November 15, 2016
First decision: January 10, 2017
Revised: January 26, 2017
Accepted: February 16, 2017
Article in press: February 17, 2017
Published online: March 14, 2017
Processing time: 119 Days and 7.2 Hours
Core Tip

Core tip: Pathologic resistance to portal venous blood flow results in elevated portal pressure, forcing blood to decompress through various portosystemic collaterals. Blood may circumvent the liver via intrathoracic, intraabdominal, abdominal wall and pelvic collateral pathways - resulting in variceal bleeding, ascites and encephalopathy. Our objective is to provide a comprehensive review of the commonly recruited portosystemic collaterals in portal hypertension and demonstrate its multimodality appearance on ultrasound, computed tomography and magnetic resonance imaging. Additionally, we will review several image-guided therapies which either aim to decrease portal venous pressure or mitigate the sequelae of portal hypertension.