COLOR DOPPLER ULTRASONOGRAPHY IN THE DIAGNOSIS OF CAVERNOUS TRANSFORMATION OF THE PORTAL-VEIN

Objective: To improve diagnostic accuracy, we studied the use of color Doppler ultrasound (CDUS) in patients with cavernous transformation o f the portal vein (CTPV). Subjects and Methods: In 18 patients, the us efulness of CDUS was compared with that of B-mode US for visualizing a nd diagnosing CTPV. Sensitivity for detecting CTPV on B-mode US, CT, a nd CDUS was also compared in 14 patients who underwent angiography whi ch showed typical findings of CTPV. In addition, we classified each pa tient based on the morphologic appearance in the ultrasound examinatio n and correlated those findings with the etiology. Results: CDUS prove d to be superior to B-mode US in identifying collateral channels and w as highly sensitive for detecting CTPV in 17 (94%) of the 18 patients. In comparison with angiography performed in 14 patients, B-mode US de tected CTPV in 9 (64%) patients, contrast-enhanced CT in 7 (50%), and CDUS in 13 (93%), indicating that CDUS was the most reliable diagnosti c tool. It was also possible to assess the etiology of CTPV using a co mbination of color Doppler findings. Detection of arterial flow patter ns within the portal vein thrombus correlated with malignant findings on histologic examination, whereas benign thrombi showed no flow signa ls. Conclusion: CDUS proved to be a reliable and useful modality for d iagnosing CTPV and evaluating the etiology of this entity. (C) 1997 Jo hn Wiley & Sons, Inc.