Diagnostic Value of Multi-slice CT in Cavernous Transformation of Portal Vein

Objective:To study the diagnostic role and CT features of cavernous transformation of portal vein(CTPV)with multi-slice CT(MSCT).Methods:A 16-detector-row spiral CT scanner was used to perform plain and multi-phase contrast enhanced abdominal scanning in 30 patients with CTPV.Image post-processing techniques,including MPR,MIP and VR,were applied to depict the cavernous transformed portal vein and its collaterals.Results:On plain MSCT,the portal vein was not clearly seen,while multiple soft tissue nodules were found in the porta hepatis region.On dynamic enhanced scans,abnormal hepatic perfusion during arterial phase in 10 cases was demonstrated.On portal vein phase images the main trunk of portal vein and/or its left and right branches were dilated with filling defects in 18 cases.Inconspicuous portal veins were shown in 4 cases.Normal main portal veins and/or left and right branches of portal vein in 8 cases were demonstrated.The main trunk of portal vein looked thin in 1 case.Pericholedochal venous plexus(100%),cystic(60%)and left gastric veins(23.3%)were dilated and varicose,looking like clusters of spots.The courses and extents of the varicose vessels were directly demonstrated with MPR,MIP and VR techniques.Conclusion:MSCT and relative image post-processing techniques were of great value in the diagnosis of CTPV.Thrombosed portal vein and its adjacent varices as well as dilated collaterals might be served as the primary features of CTPV.