IDDF2020-ABS-0050 Spiral CT in the clinical significance of portal cavernous change in hepatocellular carcinoma

Background Cavernous degeneration of portal vein (cavernous transformation of portal vein, CTPV) refers to the formation of a large number of collateral branches or recanalization after complete or partial obstruction of the main portal vein or its branches. To investigate the value of spiral CT dual phase scanning for diagnosis of portal cavernous degeneration of liver cancer. Methods 103 cases of hepatocellular carcinoma with portal cavernous change were enrolled from the First Affiliated Hospital of Sun Yat-sen University between January 01, 2015, to December 31, 2018. The abdominal CT data were analyzed, including blood vessel cross-sectional features, hepatic parenchyma perfusion, CT findings and features of portal hypertension. Results The main manifestations of CT were several small blood vessels around the portal vein in the occlusion position, the heavy ones were beaded, and the hepatic parenchyma was transient perfusion abnormality in the arterial phase, showing a zonal high-density shadow around the liver, the main findings were as follows: At the arterial stage, the hepatic parenchyma was abnormal. In the portal phase, the whole liver showed uniform density. In cirrhotic patients with portal hypertension, collateral circulation vessels (27/103), ascites (18/103), splenomegaly (45/103) were seen around the hilum of the spleen. Conclusions Spiral CT dual-phase scanning is an effective method for diagnosis of portal cavernous degeneration of liver cancer, which can provide a necessary basis for clinical treatment and prognosis.