Diagnostic value of multi-detector row spiral CT in portal vein embolism

Objective:To investigate the multi-detector row spiral CT(MSCT)features of the portal vein embolism and assess its diagnostic value in this disease.Methods:The MSCT and clinical data were reviewed and analyzed in 29 patients with portal vein embolism confirmed by clinical study and pathology,consisting of 13 cases in the thrombosis group and 16 cases in the tumor embolus group.Results:The location and size of emboli in 29 cases were clearly displayed.In the13 cases of thrombosis,9cases were secondary to liver cirrhosis portal hypertension,isodensity or slightly high density was shown on plain scan,and low density filling defect with different forms without enhancement was shown on dynamic enhancement scan.7cases showed typical target sign and 5cases showed line sign.All 16 cases of tumor embolus were secondary to liver cancer,isodensity or slightly low density was shown on plain scan,uneven enhanced filling defect with different forms on dynamic enhanced scan.The difference was statistically significant in the degree of enhancement between the two groups.There was complete obstruction in 3cases of thrombosis,incomplete obstruction in 10cases;and complete obstruction in 12 cases of tumor embolus,incomplete obstruction in 4cases.The rate of complete obstruction in the portal vein tumor embolus was higher than that in the portal vein thrombosis,the difference was statistically significant.The vascular lumen adjacent to the thrombus was expanded in 2cases,while that adjacent to the tumor embolus was expanded in 12 cases.There was local unevenness of vascular wall in one cases of thrombosis group,while that was in 14 cases of the tumor embolus group,the difference was statistically significant.Conclusion:MSCT can show the image features of the portal venous emboli,and can judge the location,extent and nature of the emboli accurately,it's of important value in the diagnosis of the disease.