Copyright ©The Author(s) 2020.
World J Gastroenterol. Jun 14, 2020; 26(22): 3000-3011
Published online Jun 14, 2020. doi: 10.3748/wjg.v26.i22.3000
Table 2 Main invasive/non invasive characteristics found in porto-sinusoidal vascular disease, extrahepatic portal vein obstruction and cirrhosis
Diagnostic toolsPSVDEHPVOCirrhosis
Invasive tools
Liver biopsyPredominant vascular anomaliesPredominant vascular anomaliesPredominant architectural changes and fibrosis
Hepatic hemodinamicsFHVP NFHVP NFHVP N
HVPG N or slightly ↑HVPG NHVPG ↑
Frequent vein-to-vein communicationsInfrequent vein-to-vein communicationsInfrequent vein-to-vein communications
Hyperdynamic circulatory stateHyperdynamic circulatory stateHyperdynamic circulatory state
Endoscopic findingsEsophageal varicesEsophageal varicesEsophageal varices
Gastric varices (GOV1, GOV2) more commonGastric varices more common (especially IGV1, IGV2)Gastric varices less common
Portal hypertensive gastropathy less commonPortal hypertensive gastropathy less commonPortal hypertensive gastropathy more common
Non invasive tools
Ultrasound examination
LiverNormal/irregular surfaceNormal/irregular surfaceIrregular surface
Homogeneous/innhomogenous parenchimaHomogeneous/innhomogenous parenchimaInnhomogenous
Focal liver lesions
Portal veinsDilatated, hyperechoic with thickened wallsChronic thrombosisDilatated
+/- spontaneous shunts+/- cavernomatous transformation+/- thrombosis
+/- thrombosis+/- portal biliopathy
SpleenOften giant splenomegalyOften giant splenomegalySplenomegaly
Porto systemic collaterals, +/- ascites
CEUS examinationDelayed periportal enhancementHomogenous/heterogenous/delayed periportal enhancement
Cross-sectional imagingHeterogeneous hepatic enhancement or paucity of the medium size portal branches(1) Better characterization of the level and extension of thrombus; and (2) Better characterization of the portal biliopathyBetter characterization of the focal liver lesions
Liver stiffenssN or slightly ↑N or slightly ↑ (less then in the PSVD)↑ (has prognostic value)
Spleen stiffness↑ (less then in PSVD or EHPVO)