Color Doppler ultrasonography in the diagnosis of cavernous transformation of the portal vein.
OBJECTIVE
To improve diagnostic accuracy, we studied the use of color Doppler ultrasound (CDUS) in patients with cavernous transformation of the portal vein (CTPV).


METHODS
In 18 patients, the usefulness of CDUS was compared with that of B-mode US for visualizing and diagnosing CTPV. Sensitivity for detecting CTPV on B-mode US, CT, and CDUS was also compared in 14 patients who underwent angiography which showed typical findings of CTPV. In addition, we classified each patient based on the morphologic appearance in the ultrasound examination and correlated those findings with the etiology.


RESULTS
CDUS proved to be superior to B-mode US in identifying collateral channels and was highly sensitive for detecting CTPV in 17 (94%) of the 18 patients. In comparison with angiography performed in 14 patients, B-mode US detected CTPV in 9 (64%) patients, contrast-enhanced CT in 7 (50%), and CDUS in 13 (93%), indicating that CDUS was the most reliable diagnostic tool. It was also possible to assess the etiology of CTPV using a combination of color Doppler findings. Detection of arterial flow patterns within the portal vein thrombus correlated with malignant findings on histologic examination, whereas benign thrombi showed no flow signals.


CONCLUSIONS
CDUS proved to be a reliable and useful modality for diagnosing CTPV and evaluating the etiology of this entity.
Ueno
N
N
Department of Gastroenterology, Jichi Medical School, Tochigi, Japan.
Sasaki
A
A
Tomiyama
T
T
Tano
S
S
Kimura
K
K
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D003097:Collateral Circulation / Q000502:physiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013924:Thrombophlebitis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D018615:Ultrasonography, Doppler, Color