OBJECTIVE: To improve diagnostic accuracy, we studied the use of color Doppler ultrasound (CDUS) in patients with cavernous transformation of the portal vein (CTPV). SUBJECTS AND METHODS: In 18 patients, the usefulness of CDUS was compared with that of B-mode US for visualizing and diagnosing CTPV. Sensitivity for detecting CTPV on B-mode US, CT, and CDUS was also compared in 14 patients who underwent angiography which showed typical findings of CTPV. In addition, we classified each patient based on the morphologic appearance in the ultrasound examination and correlated those findings with the etiology. RESULTS: CDUS proved to be superior to B-mode US in identifying collateral channels and was highly sensitive for detecting CTPV in 17 (94%) of the 18 patients. In comparison with angiography performed in 14 patients, B-mode US detected CTPV in 9 (64%) patients, contrast-enhanced CT in 7 (50%), and CDUS in 13 (93%), indicating that CDUS was the most reliable diagnostic tool. It was also possible to assess the etiology of CTPV using a combination of color Doppler findings. Detection of arterial flow patterns within the portal vein thrombus correlated with malignant findings on histologic examination, whereas benign thrombi showed no flow signals. CONCLUSION: CDUS proved to be a reliable and useful modality for diagnosing CTPV and evaluating the etiology of this entity.
OBJECTIVE: To improve diagnostic accuracy, we studied the use of color Doppler ultrasound (CDUS) in patients with cavernous transformation of the portal vein (CTPV). SUBJECTS AND METHODS: In 18 patients, the usefulness of CDUS was compared with that of B-mode US for visualizing and diagnosing CTPV. Sensitivity for detecting CTPV on B-mode US, CT, and CDUS was also compared in 14 patients who underwent angiography which showed typical findings of CTPV. In addition, we classified each patient based on the morphologic appearance in the ultrasound examination and correlated those findings with the etiology. RESULTS:CDUS proved to be superior to B-mode US in identifying collateral channels and was highly sensitive for detecting CTPV in 17 (94%) of the 18 patients. In comparison with angiography performed in 14 patients, B-mode US detected CTPV in 9 (64%) patients, contrast-enhanced CT in 7 (50%), and CDUS in 13 (93%), indicating that CDUS was the most reliable diagnostic tool. It was also possible to assess the etiology of CTPV using a combination of color Doppler findings. Detection of arterial flow patterns within the portal vein thrombus correlated with malignant findings on histologic examination, whereas benign thrombi showed no flow signals. CONCLUSION:CDUS proved to be a reliable and useful modality for diagnosing CTPV and evaluating the etiology of this entity.
Authors: Francesca R Ponziani; Maria A Zocco; Chiara Campanale; Emanuele Rinninella; Annalisa Tortora; Luca Di Maurizio; Giuseppe Bombardieri; Raimondo De Cristofaro; Anna M De Gaetano; Raffaele Landolfi; Antonio Gasbarrini Journal: World J Gastroenterol Date: 2010-01-14 Impact factor: 5.742