| Portal vein thrombosis after percutaneous ethanol injection for hepatocellular carcinoma: value of color Doppler sonography in distinguishing chemical and tumor thrombi. | |
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MedLine Citation:
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PMID: 7717218 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The distinction between benign (chemical) and tumor thromboses of the portal vein after treat,ent with percutaneous injection of ethanol for hepatocellular carcinoma is crucial for the proper management of the patient. The purpose of this study was to determine whether color Doppler sonography can be used to differentiate between the two types of thrombi. SUBJECTS AND METHODS: Between October 1991 and April 1994, portal vein thrombosis was detected by color Doppler sonography in 19 patients (13 men and six women 59-77 years old; mean age, 67 years) who had hepatocellular carcinomas and who had received percutaneous ethanol injection (n = 11) or percutaneous ethanol injection after transcatheter arterial embolization (n = 8). The criterion for diagnosing tumor thrombosis by color Doppler sonography was the detection of pulsatile arterial flow in the thrombus. The benign or malignant nature of the thrombosis was subsequently established by percutaneous fine-needle biopsy of the thrombus; malignant thrombosis was seen in 13 patients, and chemical thrombosis was seen in six patients. RESULTS: Pulsatile arterial flow in the thrombus was observed by color Doppler sonography in 12 of the 13 malignant thrombi and in none of the bland thrombi. The flow was hepatopetal in seven cases and hepatofugal in five cases. The peak systolic frequency shift ranged from 0.59 to 2.65 kHz (mean, 1.35 kHz), and the resistive index ranged from 0.37 to 0.69 (mean, 0.55). The sensitivity and the specificity of color Doppler sonography for the detection of tumor thrombosis were 92% and 100%, respectively. CONCLUSION: Our study shows that color Doppler sonography is a reliable way to differentiate between chemical and tumor thromboses of the portal vein in patients with hepatocellular carcinomas treated by ethanol injection. When the sonogram shows pulsatile arterial flow within the thrombus, percutaneous biopsy of the thrombus is unnecessary. The finding is always indicative of malignant thrombosis. |
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Authors:
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R Lencioni; D Caramella; F Sanguinetti; L Battolla; F Falaschi; C Bartolozzi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 164 ISSN: 0361-803X ISO Abbreviation: AJR Am J Roentgenol Publication Date: 1995 May |
Date Detail:
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Created Date: 1995-05-18 Completed Date: 1995-05-18 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1125-30 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, University of Pisa, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carcinoma, Hepatocellular / drug therapy*, ultrasonography* Diagnosis, Differential Ethanol / adverse effects, therapeutic use* Female Humans Injections, Subcutaneous Liver Neoplasms / complications, drug therapy*, ultrasonography Male Middle Aged Neoplastic Cells, Circulating* Portal Vein / ultrasonography* Pulsatile Flow Sensitivity and Specificity Thrombosis / chemically induced, etiology, ultrasonography* Ultrasonography, Doppler, Color* |
| Chemical | |
Reg. No./Substance:
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64-17-5/Ethanol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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