Abstract
Purpose
The aim of this study is to assess the added diagnostic value of Doppler ultrasound of the liver (DUL) performed within 3 days of contrast-enhanced CT (CECT) for the diagnosis of portal vein (PV) or hepatic vein (HV) thrombosis.
Methods
Adult patients were included if they underwent DUL within three days after a CECT of the abdomen in the emergency or inpatient setting. Retrospective review of clinical data and imaging reports was performed. In patients with discrepant or positive findings on CECT and/or DUL with respect to PV or HV thrombosis, image review was performed by three fellowship-trained abdominal radiologists in consensus.
Results
The final cohort consisted of 468 patients. Of these, 26 (5.6%) patients had equivocal findings for thrombosis on CECT, and DUL could make a confident diagnosis of positive or negative in 18 (69%) patients. Additionally, there were 2 (0.4%) patients with PV or HV thrombosis on DUL following a limited CECT, and 2 (0.4%) patients who developed interval PV thrombosis between CECT and DUL.
Conclusion
DUL after CECT added diagnostic value for PV and/or HV thrombosis in less than 5% of patients. The patency of PV and HV is often not explicitly mentioned in CECT reports at our institution, which may lead to uncertainty for the referring provider as to whether the PV and HV were adequately evaluated. Few CECT have false positive or missed or underreported findings, and a careful review of the original CECT should be performed if DUL is requested.
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DRL: conceptualization, data curation, formal analysis, investigation, writing—original draft. FPIII: conceptualization, investigation, writing—review & editing. ASS: conceptualization, investigation, writing—review & editing. MY: conceptualization, investigation, writing—review & editing, supervision.
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Ludwig, D.R., Petraglia, F.W., Shetty, A.S. et al. Limited added value of Doppler ultrasound of the liver after recent contrast-enhanced computed tomography. Abdom Radiol 46, 2567–2574 (2021). https://doi.org/10.1007/s00261-021-02950-y
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DOI: https://doi.org/10.1007/s00261-021-02950-y