title: Contrast-enhanced ultrasonography and spiral computed tomography in the detection and characterization of portal vein thrombosis complicating hepatocellular carcinoma.
abstract: The aim was to compare the performances of contrast-enhanced (CE) ultrasonography (US) and spiral computed tomography (CT) in the detection and characterization of portal vein thrombosis complicating hepatocellular carcinoma (HCC). We studied 50 patients with HCC who had biopsy-proven portal vein thrombi that had been detected with US and color Doppler US. Thirteen of the thrombi involved the main portal trunk and 37 the segmental branches. CEUS and CT were performed within a week of thrombus biopsies. For each imaging technique, diagnoses of thrombosis (present/absent) and thrombus nature (malignancy/benignancy) were made by experienced readers under blinded conditions and compared with pathological findings to determine accuracy rates for thrombus detection and characterization. Forty-four of the 50 thrombi were pathologically diagnosed as malignant and the remaining six were benign. CEUS detected 50/50 (100%) thrombi and correctly characterized 49/50 (98%). CT detected 34/50 (68%) thrombi and correctly characterized 23 of these 34 (68%). CEUS outperformed CT in terms of both thrombus detection (P < 0.0001) and characterization (P = 0.0001). CEUS appears to be significantly superior to CT for detection and characterization of portal vein thrombosis complicating HCC, and it should be considered in the staging of these tumors.
authors: VI Department of Internal Medicine and Interventional Ultrasonography, Policlinico S. Matteo Foundation, IRCCS, P.le Golgi n. 19, 27100, Pavia, Italy. s.rossi@smatteo.pv.it
authors: Sandro
authors: S
authors: Rossi
authors: Giorgia
authors: G
authors: Ghittoni
authors: Valentina
authors: V
authors: Ravetta
authors: Francesca
authors: F
authors: Torello Viera
authors: Laura
authors: L
authors: Rosa
authors: Martina
authors: M
authors: Serassi
authors: Mara
authors: M
authors: Scabini
authors: Alessandro
authors: A
authors: Vercelli
authors: Carmine
authors: C
authors: Tinelli
authors: Barbara
authors: B
authors: Dal Bello
authors: Peter N
authors: PN
authors: Burns
authors: Fabrizio
authors: F
authors: Calliada
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods; D014463:Ultrasonography / Q000379:methods; D020246:Venous Thrombosis / Q000150:complications* / Q000175:diagnosis*
chemical_list: D003287:Contrast Media