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

  • Ultrasound
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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.

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Authors and Affiliations

  1. VI Department of Internal Medicine and Interventional Ultrasonography, Policlinico “S. Matteo” Foundation, IRCCS, P.le Golgi n. 19, 27100, Pavia, Italy

    Sandro Rossi, Giorgia Ghittoni, Valentina Ravetta, Francesca Torello Viera & Laura Rosa

  2. Department of Radiology, IRCCS Policlinico “S. Matteo”, P.le Golgi n. 19, 27100, Pavia, Italy

    Martina Serassi, Mara Scabini, Alessandro Vercelli & Fabrizio Calliada

  3. Biometrics Unit, IRCCS Policlinico “S. Matteo”, P.le Golgi n. 19, 27100, Pavia, Italy

    Carmine Tinelli

  4. Department of Human Pathology, IRCCS Policlinico “S. Matteo”, P.le Golgi n. 19, 27100, Pavia, Italy

    Barbara Dal Bello

  5. Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada

    Peter N. Burns

  6. Imaging Research S660, Sunnybrook Health Science Centre, 2075 Bayview Avenue, Toronto, ON, Canada, M4N 3M5

    Peter N. Burns

Authors
  1. Sandro Rossi
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  2. Giorgia Ghittoni
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  3. Valentina Ravetta
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  4. Francesca Torello Viera
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  5. Laura Rosa
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  6. Martina Serassi
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  7. Mara Scabini
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  8. Alessandro Vercelli
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  9. Carmine Tinelli
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  10. Barbara Dal Bello
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  11. Peter N. Burns
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  12. Fabrizio Calliada
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Correspondence to Sandro Rossi.

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Rossi, S., Ghittoni, G., Ravetta, V. et al. Contrast-enhanced ultrasonography and spiral computed tomography in the detection and characterization of portal vein thrombosis complicating hepatocellular carcinoma. Eur Radiol 18, 1749–1756 (2008). https://doi.org/10.1007/s00330-008-0931-z

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  • DOI: https://doi.org/10.1007/s00330-008-0931-z

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