Hans Weskott MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To characterize the nature of portal venous thrombus by using an US contrast agent at a low MI, real time imaging mode Methods and Materials: 12 patients with thrombosis of the main, left or right portal venous branch were examined using contrast agent BR1 (SonovueTM, Bracco, Milan, Italy). ROI was continuously scanned at low MI (0.09±0.01) after intravenous administration of 2.4ml BR1 followed by a 10ml saline flash. Starting with enhancement of the hepatic artery 25 secs of the study were digitally stored continuously and later independently reviewed by the two other co-authors. At the end of the first 25sec loop another 25sec loop was stored, so that in most cases a time period of 1 min was digitally saved for review. Enhancement of the thrombus during the arterial phase was considered a reliable sign for a malignant character, non enhancement of the thrombus over one minute was considered as a sign of non malignancy. US devices: LOGIQ 7 and LOGIQ 9, 3.5CA probe, imaging mode: Digital encoded phase inversion (GE, Milwaukee, WI, USA). All patients underwent Spiral or Multislice CT and/or MR, 1/12 hemihepatectomy. Results: Portal vein thrombus in 9/12 patients showed a non homogenously distributed enhancement with visible tiny intratumoral vessels, starting 2-3 secs after enhancement of the hepatic artery. 6/9 patients with malignant thrombi were caused by HCCs, 3/9 by metastasis. 3/12 pts with portal vein thrombosis had severe infections (pneumonia, liver abscess, pankreatitis). In all cases no disagreement between the blinded reviewers was noted. CT/MR misinterpreted portal venous thrombosis in 3/12 cases. Conclusion: US contrast agent BR1 (SonovueTM) in combination with a high resolution gray scale US examination is capable to characterize portal vein thrombosis reliably with a higher diagnostic confidence when compared to other imaging modalities. (H.W. is a consultant for GE, Medical Systems, which has provided the US System and contrast software.) Questions about this event email: weskotthp@t-online.de

Weskott MD, H, Ultrasound Contrast Agent Helps to Characterize Portal Vein Thrombosis.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3103426.html