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Portal vein thrombosis other imaging findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

Contrast enhanced ultrasonography (CEUS) may be helpful in the diagnosis of portal vein thrombosis. Findings on CEUS suggestive of portal vein thrombosis include pulsatile flow in a portal vein thrombus, absence of enhancement of the portal vein thrombus in the arterial phase, and differentiate between benign and malignant portal vein thrombosis.

Other Imaging Findings

Endoscopic Ultrasound (US)

  • Endoscopic US may be helpful in the diagnosis of portal vein thrombosis. Findings on an endoscopic US suggestive of portal vein thrombosis include:[1][2][3]
    • Detecting small and non-occluding thrombi
    • Discovering portal invasion by tumors

MR angiography

  • MR angiography may be helpful in the diagnosis of portal vein thrombosis. Findings on MR angiography suggestive of portal vein thrombosis include:[4]
    • Flow direction in the portal venous system and its patency
    • Identify a cavernomatous transformation
    • Presence of varices
    • Correct function of surgical shunts

Contrast-enhanced ultrasound (CEUS)

  • Contrast-enhanced ultrasound may be helpful in the diagnosis of portal vein thrombosis. Findings on CEUS suggestive of portal vein thrombosis include:[5][6]
    • Pulsatile flow in a portal vein thrombus
    • Absence of enhancement of the portal vein thrombus in the arterial phase
    • Differentiate between benign and malignant portal vein thrombosis
Endoscopic US showing portal vein thrombosis source:S. Rajesh et al, Hindawi


References

  1. Zhang WW, Churchill S, Churchill P (1989). “Developmental regulation of D-beta-hydroxybutyrate dehydrogenase in rat liver and brain”. FEBS Lett. 256 (1–2): 71–4. PMID 2806552.
  2. Lai L, Brugge WR (2004). “Endoscopic ultrasound is a sensitive and specific test to diagnose portal venous system thrombosis (PVST)”. Am. J. Gastroenterol. 99 (1): 40–4. PMID 14687139.
  3. Hekster RE, Matricali B, Luyendijk W (1974). “Presurgical transfemoral catheter embolization to reduce operative blood loss. Technical note”. J. Neurosurg. 41 (3): 396–8. doi:10.3171/jns.1974.41.3.0396. PMID 4415192.
  4. Chawla, Y.; Duseja, A.; Dhiman, R. K. (2009). “Review article: the modern management of portal vein thrombosis”. Alimentary Pharmacology & Therapeutics. 30 (9): 881–894. doi:10.1111/j.1365-2036.2009.04116.x. ISSN 0269-2813.
  5. Ueno, Norio; Kawamura, Harunobu; Takahashi, Hirokazu; Fujisawa, Nobutaka; Yoneda, Masato; Kirikoshi, Hiroyuki; Sakaguchi, Takashi; Saito, Satoru; Togo, Shinji (2006). “Characterization of Portal Vein Thrombus With the Use of Contrast-Enhanced Sonography”. Journal of Ultrasound in Medicine. 25 (9): 1147–1152. doi:10.7863/jum.2006.25.9.1147. ISSN 0278-4297.
  6. Rajesh, S.; Mukund, Amar; Arora, Ankur (2015). “Imaging Diagnosis of Splanchnic Venous Thrombosis”. Gastroenterology Research and Practice. 2015: 1–29. doi:10.1155/2015/101029. ISSN 1687-6121.

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