Differential diagnosis of portal vein thrombus from cancer embolus by spiral CT enhancement scanning

Objective To investigate the CT images of thrombus and cancer embolus in portal vein system so as to improve the differential diagnosis for the both.Methods 40 cases of portal vein tumor emboli confirmed by clinic and pathology and 40 cases of portal vein thrombus were collected and underwent spiral CT scan and enhanced scan.Results Of 40 cases of cancer thrombus embolism,22 cases of tumor emboli exhibited low density under the plain CT scan(55.0%),36 cases were completeness embolism(90.0%),30 cases presented with portal vein lumen enlargement(75.0%),27 cases of tumor thrombus were attached to the wall leading to be the rough and strengthened blood vessel walls,as well as the strengthened embolus(67.5%),and 23 cases formed arteriovenous fistula(57.5%).Of 40 cases of thrombus embolism,22 cases of tumor emboli exhibited low density under the plain CT scan(55.0%),7cases of tumor emboli were completeness embolism(17.5%),10 cases presented with portal vein lumen enlargement(25.0%),40 cases of thrombus were attached to the wall that was still continuous,smooth,and soft,without enhancement of thrombosis.None had appeared the arteriovenous fistula.Conclusion CT manifestations of thrombus and cancer embolus in the portal vein system have different characteristic features in terms of density,enhancement,invasion to blood wall,thrombosis position,and collateral circulation.