CARDIOPHRENIC VARICES IN PORTAL-HYPERTENSION - EVALUATION WITH CT

PURPOSE: To determine the prevalence and appearance of cardiophrenic a ngle (CPA) varices at computed tomography (CT) in patients with portal hypertension (PHT). MATERIALS AND METHODS: A retrospective review was performed of 148 consecutive contrast material-enhanced abdominal CT scans of patients with PHT. The paracardiac region was assessed for tu bular structures suggestive of varices. Variceal diameter and CT atten uation relative to adjacent liver were noted. RESULTS: Tubular structu res consistent with CPA varices were noted in 29 cases and were more c ommon on the right side than on the left. Mean CPA variceal diameter w as 2.6 mm. In three cases, right CPA varices measured 10-13 mm in diam eter, but no variceal enhancement was noted on initial dynamic CT imag es. Delayed CT demonstrated contrast enhancement that reflected delaye d enhancement of the portal venous system. CONCLUSION: CPA varices, pa rticularly on the right side, are not uncommon in patients with PHT. V arices should be considered and excluded as a cause of CPA masses, par ticularly before percutaneous biopsy. Delayed CT may be necessary to c orrectly delineate CPA varices.