Contrast-enhanced ultrasonography and spiral computed tomography in the detection and characterization of portal vein thrombosis complicating hepatocellular carcinoma

Sandro Rossi, Giorgia Ghittoni, Valentina Ravetta, Francesca Torello Viera, Laura Rosa, Martina Serassi, Mara Scabini, Alessandro Vercelli, Carmine Tinelli, Barbara Dal Bello, Peter N. Burns, Fabrizio Calliada

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1749-1756
Number of pages8
JournalEuropean Radiology
Volume18
Issue number8
DOIs
Publication statusPublished - Aug 2008

Keywords

  • Computed tomography
  • Contrast-enhanced ultrasonography
  • Hepatocellular carcinoma
  • Portal vein thrombosis
  • Ultrasonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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