Contrast-Enhanced color doppler US in malignant portal vein thrombosis

Abstract

Contrast-enhanced Doppler US is a reliable diagnostic tool for assessing malignant portal vein thrombosis.

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

“…Its sensitivity proved to be significantly higher than that of triphasic spiral CT for both the detection and characterization of portal vein thrombosis, and in the latter setting, it was also significantly more sensitive than cDUS, confirming previous reports [18][19][20][21].…”

“…Arterial neovascularization within a neoplastic thrombus results in arterial enhancement, which, on real-time imaging, can be easily distinguished from venous enhancement by its intermittent pulsation. Confirmation of the signal's arterial nature with Doppler spectral analysis has been shown to indicate malignancy with very high specificity [18][19][20][21]. False positives caused by the incorrect placement of the Doppler sample volume at a point in which the hepatic artery crosses over the portal vein has been reported for CEUS [20] and for cDUS [6].…”

“…Thus far, intra-arterial digital subtraction angiography has been regarded as the "gold standard" for detection of portal-vein thrombosis [10,11], although other noninvasive radiological techniques have also been proposed for this purpose [12][13][14][15][16][17][18][19][20][21]. Tri-phasic spiral computed tomography (CT) is used worldwide for the non-invasive assessment of the portal system [12,13], and it is considered a fundamental tool for the detection of portalvein thrombosis.…”

Characterization of focal liver lesions using contrast-enhanced sonography with a low mechanical index mode and a sulfur hexafluoride-filled microbubble contrast agent

“…CEUS has the potential of playing an important role in this respect. 26 In our study, the image analysis was performed in consensus instead independently between readers, which might lead to bias even though this method is widely used. Further studies are needed to assess the differences in characterization among different observers with an aim to evaluate the reliability and acceptance of CEUS.…”

Ultrasound contrast agents: clinical applications

“…From our own experience using Levovist, the diagnosis can be more confident, both in harmonic and colour Doppler modes after contrast injection. The detection of flow within the thrombus may also be improved [26].…”