放射科医生熟悉正常门静脉的外观；其解剖结构的变化很常见，由于对手术的影响，需要仔细考虑。门静脉解剖结构的这些改变具有特征性外观，可以在 CT、MR 和 US 图像上清楚地描绘出来。同样，有许多先天性和后天性门静脉疾病对其功能有害，并且可以仅通过成像来诊断。其中一些病症具有微妙的影像学特征，而另一些病症在影像学上很明显，但人们对其知之甚少或认识不足。作者检查了门静脉的影像学表现，首先概述了经典和变异的解剖结构，然后描述了影响门静脉功能的每种疾病。本综述讨论的门静脉异常的影像学表现包括（a）静脉内无性血栓和肿瘤的闭塞和区分，以及与由此产生的肝动脉缓冲反应变化、门静脉海绵样变和门胆病相关的变化； (b) 门静脉上行血栓性静脉炎（门静脉炎）； (c) 门脉高压及其原因和后遗症； (d)新描述的疾病实体门窦血管疾病； (e) 先天性和后天性门静脉系统的肝内和肝外分流（包括阿伯内西畸形）以及相关风险。目前对这些疾病的病理生理过程的了解被认为有助于报告方法。 ©RSNA，2023 本文的测验问题可在补充材料中找到。

Radiologists are familiar with the appearances of a normal portal vein; variations in its anatomy are commonplace and require careful consideration due to the implications for surgery. These alterations in portal vein anatomy have characteristic appearances that are clearly depicted on CT, MR, and US images. Similarly, there are numerous congenital and acquired disorders of the portal vein that are deleterious to its function and can be diagnosed by using imaging alone. Some of these conditions have subtle imaging features, and some are conspicuous at imaging but poorly understood or underrecognized. The authors examine imaging appearances of the portal vein, first by outlining the classic and variant anatomy and then by describing each of the disorders that impact portal vein function. The imaging appearances of portal vein abnormalities discussed in this review include (a) occlusion from and differentiation between bland thrombus and tumor in vein and the changes associated with resultant hepatic artery buffer response changes, cavernous transformation of the portal vein, and portal biliopathy; (b) ascending thrombophlebitis of the portal vein (pylephlebitis); (c) portal hypertension and its causes and sequelae; (d) the newly described disease entity portosinusoidal vascular disorder; and (e) intra- and extrahepatic shunts of the portal system, both congenital and acquired (including Abernethy malformations), and the associated risks. Current understanding of the pathophysiologic processes of each of these disorders is considered to aid the approach to reporting. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.