Sonographic features of portal vein thrombosis

Gansbeke, Daniel Van; Ef, Avni; Delcour, Christian; Engelholm, L; Struyven, Julien

doi:10.2214/ajr.144.4.749

Cited by 141 publications

(64 citation statements)

References 5 publications

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“…It shows solid isoechoic or hypoechoic material within portal vein either filling the lumen partially or complete. 88 It is the least expensive method but sensitivity and specificity is affected by interpatient variability and expertise of the given radiologist. 89 Overall the sensitivity and specificity of ultrasound for detecting portal vein thrombosis ranges from 80 to 100% with an accuracy of 88-98%.…”

Section: Ultrasoundmentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

150

147

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Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. ( J CLIN EXP HEPATOL 2015;5:22-40)

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Section: Ultrasoundmentioning

confidence: 99%

Portal Vein Thrombosis

Chawla

Bodh

2015

Journal of Clinical and Experimental Hepatology

150

147

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“…In most patients, gray-scale and Doppler US allow the non-invasive diagnosis of PVT by demonstrating the presence of hyperechoic material within the portal vein, distension of the portal vein and its tributaries, and total or partial absence of flow [15].…”

Section: Gray-scale (B-mode Imaging) and Doppler Us In The Diagnosis mentioning

confidence: 99%

“…The thrombus echogenicity can be hypo-, hyper-or isoechoic in standard US and its echogenity is not predictive for the nature of PVT (benign or malignant), but the presence of an adjacent liver mass to the PVT is highly predictive for malignant PVT [15] (fig 1a). Sometimes, a recently formed thrombus may be anechoic and thus can be missed by standard US examination [15].…”

Section: Gray-scale (B-mode Imaging) and Doppler Us In The Diagnosis mentioning

confidence: 99%

Portal vein thrombosis in liver cirrhosis – the added value of contrast enhanced ultrasonography.

et al. 2016

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Portal vein thrombosis (PVT) is a frequent complication of liver cirrhosis and its prevalence increases with the severity of liver disease. Patients with liver cirrhosis and hepatocellular carcinoma may have either malignant or blunt (benign) PVT. In these patients, the diagnosis and characterization of PVT is important for the prognosis and further treatment.Ultrasound (US) is the modality of choice for the diagnosis of PVT. The features of PVT on B-mode (gray-scale) US include: dilatation of the portal vein, visualization of the thrombus and, in chronic PVT-cavernous transformation. Sensitivity of US in the diagnosis of PVT is improved by the use of Doppler US and of ultrasound contrast agents. In the latter years, contrast enhanced ultrasound (CEUS) showed high sensitivity in the differential diagnosis between benign and malignant PVT and could be the diagnostic method of choice for the characterization of PVT. Blunt thrombi are avascular and will not enhance during CEUS examination, while a hyperenhancement pattern of the portal thrombus in the arterial phase, with "wash out" in the portal or late phase is typical for malignant PVT.

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“…The angiographic, CT, and sonographic diagnoses of portal venous thrombosis (PVT) have been well described [1][2][3][4][5][6]. IV contrast enhancement, particularly with dynamic rapid-sequence scanning, is essential for the CT diagnosis of PVT [2], whereas pulsed Doppler is a valuable supplement to real-time sonography for diagnosing this condition [5,6].…”

mentioning

confidence: 99%