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European Radiology

, Volume 18, Issue 8, pp 1749–1756 | Cite as

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

  • Sandro RossiEmail author
  • 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
Ultrasound

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.

Keywords

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

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Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Sandro Rossi
    • 1
    Email author
  • Giorgia Ghittoni
    • 1
  • Valentina Ravetta
    • 1
  • Francesca Torello Viera
    • 1
  • Laura Rosa
    • 1
  • Martina Serassi
    • 2
  • Mara Scabini
    • 2
  • Alessandro Vercelli
    • 2
  • Carmine Tinelli
    • 3
  • Barbara Dal Bello
    • 4
  • Peter N. Burns
    • 5
    • 6
  • Fabrizio Calliada
    • 2
  1. 1.VI Department of Internal Medicine and Interventional UltrasonographyPoliclinico “S. Matteo” Foundation, IRCCSPaviaItaly
  2. 2.Department of RadiologyIRCCS Policlinico “S. Matteo”PaviaItaly
  3. 3.Biometrics Unit, IRCCS Policlinico “S. Matteo”PaviaItaly
  4. 4.Department of Human PathologyIRCCS Policlinico “S. Matteo”PaviaItaly
  5. 5.Department of Medical BiophysicsUniversity of TorontoTorontoCanada
  6. 6.Imaging Research S660, Sunnybrook Health Science CentreTorontoCanada

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