Tumor thrombus of the portal vein in hepatocellular carcinoma: multi-slice spiral CT features and clinical significance

Objective To evaluate the relation of dynamic enhanced multi-slice spiral CT (MSCT) features and the generative mechanisms of tumor thrombus of the portal vein (TTPV) in hepatocellular carcinoma (HCC), and to assess the CT diagnostic advantage and clinical value. Methods Two hundred and sixty-eight patients with HCC received dynamic enhanced MSCT scan of the liver and 56 cases with TTPV were found. MSCT signs of 56 cases with TTPV were studied and analyzed with DSA findings. Results All the 56 patients with TTPV had positive CT findings related to TTPV, which were dilation of portal vein (PV), filling defect within and PV casting, network artery in embolus and surroundings of PV, arterioportal shunt (APS) and hepatic abnormal perfusion. Three cases had no positive DSA findings related to TTPV. Conclusion The dynamic enhanced MSCT can assess the TTPV's generative mechanisms, blood-supplying source and abundance, benignity or malignancy and extend of embolus, combined APS or not and shunting quantity, and relationship with surrounding structures. MSCT diagnosis of TTPV is of important clinical significance in the treatment of HCC.