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Click 80 year-old women with an incidentally noted intrahepatic portal vein aneurysm. Contrast-enhanced axial and coronal CT images in the portal venous phase (Siemens Sensation 64 detector scanner, 200 mAs, 120 kV, 5 mm slice thickness, 100 mL Isoview 370(r), Bracco Diagnostics Inc.) demonstrate a 3.3 x 2.9 x 3.1 cm portal vein aneurysm at the bifurcation of the right and left portal venous branches. Note the mural calcification on the nonenhanced images. The liver has a nodular contour consistent with cirrhosis, and there is sequela of portal hypertension including splenomegaly and a recanalized umbilical vein.

Click 23 year-old woman status post orthotopic liver transplantation presents with a partially thrombosed portal vein aneurysm. Grayscale, color Doppler, and pulsed Doppler ultrasound images of the liver (curved array 5.0-2.0 MHz transducer). There is a 9.1 x 7.8 x 5.1 cm anechoic, intrahepatic structure which demonstrates internal color flow. This structure is contiguous with the main portal vein, as evident by the monophasic waveform, consistent with a portal vein aneurysm. Mural-adherent intraluminal echogenic substance with surrounding color flow is consistent with nonocclusive portal vein thrombus.

Click 23 year-old woman status post orthotopic liver transplantation presents with portal venous system aneurysms. Five minute delayed contrast-enhanced coronal fat-saturated T1-weighted imaging from a MRA/MRV (Siemens Sonata 1.5 Tesla magnet, fast-low-angle-shot sequence, TR/TE 5.9/1.9 msec, 1.5 mm slice thickness, 25 mL Magnevist(r), Bayer) clearly illustrates communication of the enhancing structure with the intrahepatic portal vein. The splenic and superior mesenteric veins are also.

Click 51 year-old man with a right temporal-parietal infarct and extrahepatic portal vein aneurysm. Coronal fat-saturated T1-weighted imaging with contrast of the abdomen during portal venous phase (1.5 Tesla magnet, 3D gradient-recalled-echo sequence, TR/TE 4.8/2.3 msec, 3 mm slice thickness, 12 mL Magnevist(r), Bayer). There is a 3.5 x 2.3 x 3.3 cm mass in the region of the pancreatic uncinate process which is hypointense on T1-weighted imaging and enhances, eventually found to represent an extrahepatic portal vein aneurysm on endoscopic ultrasound (not shown). Possible mass effect on the portal vein secondary to the aneurysm is suggested. A right renal cyst is incidentally noted.

Click 61 year-old female with recurrent hepatocellular carcinoma and an extrahepatic portal vein aneurysm. Axial and coronal contrast-enhanced CT imaging of the abdomen in the portal venous phase (Siemens Sensation 64 slice scanner, 200 mA, 120 kV, 5 mm slice thickness, 100 mL Isoview 370(r), Bracco Diagnostics Inc.). There is a 1.5 x 1.6 x 1.1 cm saccular dilatation of the portal-superior mesenteric venous confluence, consistent with a portal vein aneurysm. Nodularty of the hepatic contour compatible with cirrhosis and mild splenomegaly are noted.