ABSTRACT
Objective To observe the multi-slice spiral CT manifestations of cavernous transformation of the portal vein (CTPV) secondary to tumor emboli from hepatocellular carcinoma (HCC). Methods MSCT manifestations of 31 patients of HCC with tumor emboli-induced CTPV proved by operation and pathology were collected and the data were retrospectively analyzed. Results Tumor embolus was detected in both the trunk, left and right branches of PV in 23 patients, accompanied with superior mesenteric vein and/or splenic vein and inferior vena cava's tumor embolus in 4 and infiltration of gallbladder in 1 of 23 patients, as well as in the trunk and left branch in 1, and in the trunk and right branch of PV in 5 patients, accompanied with right hepatic vein and/or inferior vena cava's tumor embolus in 2 and in the portal trunk and superior mesenteric vein in 1, only in the right branch in 1 patient, respectively. Tumor emboli were isodense in plain CT scan, but enhanced with obvious degrees in arterial phase and filling defects in portal venous phase. There were collateral vessels around portal vein. Lateral branches around hilar bile duct, the open of venous plexus around fossa of gallbladder, lateral veins around gastric fundus and lesser curvature, lateral veins of lower part of esophagus and expansion of splenic vein were found in 31 (100%), 19 (61.29%), 21 (67.74%), 7 (22.58%) and 15 patients (48.38%), respectively. Conclusion Tumor emboli-induced CTPV from HCC has specific MSCT findings being helpful to the diagnosis.