Diagnosis of portal vein thrombosis discontinued with liver tumors in patients with liver cirrhosis and tumors by contrast-enhanced US: A pilot study

Song, Ze–Zhou; Huang, Min; Zhao, Qiyu; Yao, Lihua; Mou, Yun; Zhao, Jingbo; Ao, Jian; Chen, Fen; Chen, Yan

doi:10.1016/j.ejrad.2009.04.021

Cited by 23 publications

(26 citation statements)

References 14 publications

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“…High alpha fetoprotein level, endovascular obstruction adjacent to the tumor, enlargement of the vessel by the endovascular material and enhancement of the intravascular material at the arterial phase on imaging are consistent with tumor invasion [22]. Contrast-enhanced ultrasonography (US) may also help distinguish malignant invasion from cruoric thrombosis by showing an arterial signal within the endoluminal material [23].…”

Section: Incidence Mechanisms and Consequences Of Portal Vein Thrommentioning

confidence: 96%

Portal vein thrombosis, cirrhosis, and liver transplantation

Francoz

Valla

Durand

2012

Journal of Hepatology

223

265

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Section: Incidence Mechanisms and Consequences Of Portal Vein Thrommentioning

confidence: 96%

Portal vein thrombosis, cirrhosis, and liver transplantation

Francoz

Valla

Durand

2012

Journal of Hepatology

223

265

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“…Both Doppler ultrasonography and multiphasic computed tomography have high sensitivity and specificity for detection of PVT. [48][49][50] Doppler US is highly accurate at detecting thrombosis involving the trunk of the portal vein and in intrahepatic branches.…”

Section: Diagnosis Of Pvt In Cirrhosismentioning

confidence: 99%

Portal Vein Thrombosis in Cirrhosis

Raja

Jacob

Asthana

2014

Journal of Clinical and Experimental Hepatology

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Portal vein thrombosis (PVT) is being increasingly recognized in patients with advanced cirrhosis and in those undergoing liver transplantation. Reduced flow in the portal vein is probably responsible for clotting in the spleno-porto-mesenteric venous system. There is also increasing evidence that hypercoagulability occurs in advanced liver disease and contributes to the risk of PVT. Ultrasound based studies have reported a prevalence of PVT in 10-25% of cirrhotic patients without hepatocellular carcinoma. Partial thrombosis of the portal vein is more common and may not have pathophysiological consequences. However, there is high risk of progression of partial PVT to complete PVT that may cause exacerbation of portal hypertension and progression of liver insufficiency. It is thus, essential to accurately diagnose and stage PVT in patients waiting for transplantation and consider anticoagulation therapy. Therapy with low molecular weight heparin and vitamin K antagonists has been shown to achieve complete and partial recanalization in 33-45% and 15-35% of cases respectively. There are however, no guidelines to help determine the dose and therapeutic efficacy of anticoagulation in patients with cirrhosis. Anticoagulation therapy related bleeding is the most feared complication but it appears that the risk of variceal bleeding is more likely to be dependent on portal pressure rather than solely related to coagulation status. TIPS has also been reported to restore patency of the portal vein. Patients with complete PVT currently do not form an absolute contraindication for liver transplantation. Thrombectomy or thromboendovenectomy is possible in more than 75% of patients followed by anatomical end-to-end portal anastomosis. When patency of the portal vein and/or superior mesenteric vein is not achieved, only non-anatomical techniques (reno-portal anastomosis or cavo-portal hemitransposition) can be performed. These techniques, which do not fully reverse portal hypertension, are associated with higher morbidity and mortality risks in the short term. ( J CLIN EXP HEPATOL 2013;4:320-331)

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“…In a recent study of 54 HCC patients with PVTT, Tarantino et al [12] found that CEUS with a contrast-enhancing agent (SonoVue; Bracco SpA, Milan, Italy) was an effective means of detecting PVTT, and that it was more sensitive (88%) and more accurate (92.5%) than fineneedle biopsy (sensitivity 76%, accuracy 78.7%). Song et al [13] found that CEUS with SonoVue showed early enhancement in all 14 HCC patients with PVTT (sensitivity 100%) and absence of thrombosis enhancement in two of three benign PV thromboses (specificity 66.7%). The results of these studies suggest that evaluation of PV blood flow is important to making a diagnosis of PVTT.…”

Section: Discussionmentioning

confidence: 97%

“…A recent study reported clear visualization of the thread and streaks sign by contrast-enhanced ultrasonography (CEUS) [12,13]. However, to the best of our knowledge, there has never been a report of evaluation of PVTT by CEUS before and after hepatic arterial infusion chemotherapy (HAIC).…”

Section: Introductionmentioning

confidence: 96%

Evaluation of hepatocellular carcinoma with portal vein tumor thrombosis by CEUS before and after hepatic arterial infusion chemotherapy

et al. 2010

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Hepatocellular carcinoma (HCC) is one of the most common neoplasms worldwide. Portal vein tumor thrombosis (PVTT) is a common complication of advanced HCC, and the prognosis of advanced HCC with PVTT is extremely poor. We report a case of HCC with PVTT evaluated by contrast-enhanced ultrasonography (CEUS) before and after hepatic arterial infusion chemotherapy (HAIC). A 59-year-old man with chronic hepatitis C was admitted to our hospital. CEUS clearly showed the thread and streaks sign in a solid lesion that occupied the right main branch of the portal vein. HAIC was performed, and CEUS after HAIC clearly showed disappearance of the thread and streaks sign. CEUS was very useful in diagnosing PVTT and in evaluating the effectiveness of HAIC in this case.

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Diagnosis of portal vein thrombosis discontinued with liver tumors in patients with liver cirrhosis and tumors by contrast-enhanced US: A pilot study

Cited by 23 publications

References 14 publications

Portal vein thrombosis, cirrhosis, and liver transplantation

Portal vein thrombosis, cirrhosis, and liver transplantation

Portal Vein Thrombosis in Cirrhosis

Evaluation of hepatocellular carcinoma with portal vein tumor thrombosis by CEUS before and after hepatic arterial infusion chemotherapy

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