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Congress: ECR25
Poster Number: C-17042
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-17042
Authorblock: A. S. Zmarandescu, D. Cuzino; Bucuresti/RO
Disclosures:
Andreea Sabrina Zmarandescu: Nothing to disclose
Dragos Cuzino: Nothing to disclose
Keywords: Abdomen, Oncology, Vascular, CT, Contrast agent-intravenous, Structured reporting, Cancer, Embolism / Thrombosis, Neoplasia
Learning objectives To highlight the importance of a systematic approach and a structured report. To provide a brief review of portal vein tumor thrombosis associated with hepatocelullar carcinoma. To describe the most common contrast-enhanced CT (CECT) signs that appear in this condition. To understand the importance of recognising portal vein tumor thrombosis (PVTT) in Hepatocellular carcinoma (HCC) for determining prognosis and guiding patient treatment.
Read more Background Hepatocellular carcinoma is the most prevalent type of primary liver tumor, and its incidence has been rising in recent years.Portal vein involvement is one of the most concerning complications of HCC, making early diagnosis crucial. This condition is linked to a poor prognosis, as it is strongly associated with intrahepatic metastasis and tumor recurrence. Even with the best supportive care, patients typically have only a few months of overall survival. In this condition, treatment options are limited, and the best...
Read more Findings and procedure details HCC enhancement on CECT is visible during the arterial phase, as it is a hypervascular tumor primarily supplied by the hepatic artery, often displaying a "mosaic" pattern of enhancement. It rapidly washes out, becoming hypoattenuating compared to the liver parenchyma during the portal venous or delayed phase, with a pseudocapsule forming around the nodule. [fig 1] [fig 2] [fig 3] PVTT is a well-recognized complication of HCC, and its diagnosis should be made using contrast-enhanced imaging during the portal venous phase. Given the invasiveness of portal...
Read more Conclusion A systematic approach to this pathology aids in accurately monitoring and characterizing the disease, leading to a well-defined final diagnosis. Diagnosing portal vein tumor thrombosis in HCC patients is crucial due to its poor prognosis and reliance on palliative treatment.CECT is an invaluable tool for both diagnosis and identifying complications.CT is the primary modality for characterization of PVTT, due to its advantages compared to other types of investigation: It is fast and accessible. It follows the extent of thrombosis, signs of bowel...
Read more References Shi B, Bian C, Li Z, Chen J, Yang D, Li Y, Hao X, Ping Y. Imaging findings of hepatocellular carcinoma with portal vein tumor thrombosis secondary to hepatic portal vein collateral circulation: a cross-sectional study. J Gastrointest Oncol. 2023 Feb 28;14(1):334-351. doi: 10.21037/jgo-23-45. Epub 2023 Feb 15. PMID: 36915456; PMCID: PMC10007947. Canellas R, Mehrkhani F, Patino M, Kambadakone A, Sahani D. Characterization of Portal Vein Thrombosis (Neoplastic Versus Bland) on CT Images Using Software-Based Texture Analysis and Thrombus Density (Hounsfield...
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