| Diagnosis of portal vein thrombosis discontinued with liver tumors in patients with liver cirrhosis and tumors by contrast-enhanced US: a pilot study. | |
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MedLine Citation:
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PMID: 19464131 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: We assessed the role of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant portal vein thrombosis (PVT) in patients who had liver tumors. METHODS: Seventeen consecutive patients who had cirrhosis, liver tumors, and PVT were prospectively studied with CEUS. CEUS was performed at low mechanical index after intravenous administration of a second-generation contrast agent (SonoVue, Bracco, Milan, Italy). Presence or absence of thrombus enhancement on CEUS were considered diagnostic for malignant or benign PVT. Five patients also underwent percutaneous portal vein fine-needle biopsy under US guidance. All patients were followed-up. Shrinkage of the thrombus and/or recanalization of the vessels on CDUS during follow-up were considered definitive evidence of the benign nature of the thrombosis, whereas the enlargement of the thrombus, disruption of the vessel wall, and parenchymal infiltration over follow-up were considered consistent with malignancy. RESULTS: Follow-up showed signs of malignant thrombosis in 14 of 17 patients. CEUS showed early arterial enhancement of the PVT in 14 patients of 14 malignant PVT, 1 patient of 3 benign PVT and the absence of thrombus enhancement in 2 patients of 3 benign PVT. FNB confirmed the results for malignant PVT in four of five patients, for benign granulomatous inflammation PVT in one of five patients in which CEUS showed early arterial enhancement of the PVT. The sensitivity, specificity and accuracy is 100%, 66.7% and 93.3% at diagnosis of malignant PVT using CEUS. In one patient with intrahepatic bile duct stone, CEUS were positive for malignant PVT, whereas FNB was negative (benign granulomatous inflammation PVT); follow-up examination confirmed benign PVT. CONCLUSION: CEUS seems to be the pretty sensitive and specific test for diagnosing malignant portal vein thrombosis in patients with cirrhosis and tumors. |
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Authors:
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Ze-Zhou Song; Min Huang; Tian-An Jiang; Qi-Yu Zhao; Lei Yao; Yun Mou; Jun-Kang Zhao; Jian-Yang Ao; Fen Chen; Yan Chen |
Publication Detail:
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Type: Journal Article Date: 2009-05-22 |
Journal Detail:
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Title: European journal of radiology Volume: 75 ISSN: 1872-7727 ISO Abbreviation: Eur J Radiol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-13 Completed Date: 2010-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106411 Medline TA: Eur J Radiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 185-8 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, China. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Contrast Media* Female Humans Liver Cirrhosis / complications*, pathology, ultrasonography* Liver Neoplasms / complications*, pathology, ultrasonography* Male Middle Aged Phospholipids / diagnostic use* Portal Vein / ultrasonography* Sensitivity and Specificity Sulfur Hexafluoride / diagnostic use* Venous Thrombosis / complications, pathology, ultrasonography* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Phospholipids; 0/contrast agent BR1; 2551-62-4/Sulfur Hexafluoride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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