CT appearance and differential diagnosis of thrombus in portal vein

Objective To study the CT images of thrombus in portal vein and describe its features and summarize further discrimination with cancer embolus. Methods 18 cases confirmed by autopsy and therapy were examined with CT, and analysis its traits in CT images. Results In 18 cases of thrombus embolism, 15 cases occurred in trunk vein, 10 cases in right branch, 7cases in left branch, 6 cases in splenic vein and 4 cases in superior mesenteric vein; 5 cases showed high-dense in thrombus and 8 cases appear iso-dense and 2 cases in low-dense; 13 benign embolism cases presented partial filling defect, which was described as stripe and bundles in contrasted vein; All cases with thrombus showed smooth and successive in involved vein wall; 5 cases of thrombus lead to dilation of the involved vein; 10 cases displayed collateral circulation in esophagogastric and splenic vein, whereas 2 cases displayed pericholecystic and pericholedochal collateral branches; no cases visualized A-P shunt in all thrombus embolism. Conclusions There are great differentiation in some aspects such as embolus' position and shapes, involved vein and collateral circulation between benign and malignant embolism and so on. All above mentioned will be the great help to improve the accurate diagnosis of the portal vein embolism.