Diagnosis of portal vein tumor thrombus:the combination of enhanced multislice spiral computed tomography and portography

AIM:To evaluate the value of combined enhanced 16-slice spiral CT and portography reconstruction in the diagnosis of portal vein tumor thrombus.METHODS:Fifty-two patients with portal vein tumor thrombus underwent 16-slice spiral CT examination.A plain scan and triple-phase enhanced scans(arterial phase,portal venous phase,and equilibrium phase) were performed.Scanning parameters were as follows:a slice thickness of 2.5 mm,a reconstruction interval of 0.625 mm,a flow rate of 3.5-4 mL/s,80-100 mL of contrast agent,and scan time of 25-30 s,45-60 s,and 120 s,respectively.Image reformation,including volume rendering(VR),multiplanar reformation(MPR) and maximum intensity projection(MIP),was performed by one radiologist.Two radiologists assessed the scope,shape and collateral vessels of the thrombus.RESULTS:Thirty-five cases(67.3%) of portal vein tumor thrombus showed inhomogeneous enhancement in the arterial phase,and 47 cases(90.4%) had the enlarged portal vein and filling defect.Enhancement of the vessel wall was seen in 19 cases(36.5%),collateral circulation formation in 13 cases(25%),compression of the portal vein in 13 cases(25%),and arterioportal fistula in 6 cases(11.5%).Different portal vein reconstruction techniques showed different number of cases of portal vein tumor thrombus:52(100%) by MPR,43(82.7%) by MIP,39(75%) by VR.CONCLUSION:The combination of enhanced CT and portography reconstruction can reveal portal vein tumor thrombus completely and has important clinical value.