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Objective <p>To characterize portal vein (PV) confluence variants on contrast-enhanced CT, quantify the inferior mesenteric vein (IMV)–to–confluence distance by variant, and report previously undescribed configurations.</p> Methods <p>We first labeled variants using an extended 14-type scheme (Prado I–XII plus two new types XIII–XIV). For comparability with prior literature, these were then collapsed to three drainage categories (Thomson I/II/III: IMV → SV, true trifurcation at the SMV–SV junction, IMV → SMV) for distance analyses.</p> Results <p>After recoding to three drainage categories, the distribution was Type I/II/III = 45.7% (91/199) / 19.1% (38/199) / 34.7% (69/199). Two additional, previously unclassified variants (Types XIII–XIV) were identified on CT in 5/199 patients (2.5%). One case (Type XII, dual IMV) could not be assigned to a single drainage category and was excluded from the three-group comparisons (N = 198). Median IMV–to–confluence distances differed: 17.9&#xa0;mm (Type I; interquartile range [IQR] 13.3–23.0), 0.0&#xa0;mm (Type II; IQR 0.0–0.0), and 5.0&#xa0;mm (Type III; IQR 3.5–7.0) (Kruskal–Wallis χ<sup>2</sup> = 159.12, <i>p</i> &lt; 0.001; N = 198). Group differences were tested with Kruskal–Wallis and Bonferroni-adjusted pairwise Mann–Whitney U; agreement was assessed with Cohen’s κ and ICC(2,1).</p> Conclusion <p>Classic PV confluence types predominate, but rare/novel configurations are present. The association between IMV drainage route and IMV–to–confluence distance supports variant-aware preoperative CT review to inform operative planning and patient safety.</p>

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Portal vein confluence variants on contrast-enhanced CT: distribution, IMV–confluence distance, and novel patterns in 199 adults

  • 期刊论文

  • 发表日期：

    2025年10月21日

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  • Phuong Thi Mai,
  • Van Trung Hoang,
  • Thien Thanh Thi Nguyen,
  • Thuy Hang Thi Vo,
  • Van Phuoc Le

摘要

Objective

To characterize portal vein (PV) confluence variants on contrast-enhanced CT, quantify the inferior mesenteric vein (IMV)–to–confluence distance by variant, and report previously undescribed configurations.

Methods

We first labeled variants using an extended 14-type scheme (Prado I–XII plus two new types XIII–XIV). For comparability with prior literature, these were then collapsed to three drainage categories (Thomson I/II/III: IMV → SV, true trifurcation at the SMV–SV junction, IMV → SMV) for distance analyses.

Results

After recoding to three drainage categories, the distribution was Type I/II/III = 45.7% (91/199) / 19.1% (38/199) / 34.7% (69/199). Two additional, previously unclassified variants (Types XIII–XIV) were identified on CT in 5/199 patients (2.5%). One case (Type XII, dual IMV) could not be assigned to a single drainage category and was excluded from the three-group comparisons (N = 198). Median IMV–to–confluence distances differed: 17.9 mm (Type I; interquartile range [IQR] 13.3–23.0), 0.0 mm (Type II; IQR 0.0–0.0), and 5.0 mm (Type III; IQR 3.5–7.0) (Kruskal–Wallis χ2 = 159.12, p < 0.001; N = 198). Group differences were tested with Kruskal–Wallis and Bonferroni-adjusted pairwise Mann–Whitney U; agreement was assessed with Cohen’s κ and ICC(2,1).

Conclusion

Classic PV confluence types predominate, but rare/novel configurations are present. The association between IMV drainage route and IMV–to–confluence distance supports variant-aware preoperative CT review to inform operative planning and patient safety.