The practice of routinely evaluating the portal vein as part of a right upper quadrant sonography study may have value as a screening mechanism for portal vein thrombosis. Difficulties arise in differentiating thrombosis from tumor as the source of portal vein obstruction. This case study of portal tumor thrombosis (PTT) due to hepatocellular carcinoma is a good example of the use of multiple modalities to arrive at the definitive diagnosis. Many studies have been conducted on the effectiveness of magnetic resonance imaging and computed tomography on the accurate diagnosis of PTT, but few cases have been reported that used a multimodality approach.
2. Ueno N, Tomiyama T, Tano S, Wada S, Miyata T: Color Doppler ultrasonography in the diagnosis of portal vein invasion in patients with pancreatic cancer. JUM1997;16:825-830.
3.
3. Callaway M, Fields J, Hawnaur J: An unusual metastatic involvement. Br J Radiol1998;71:239-240.
4.
4. Ishida H, Konno K, Hamashima Y, Naganuma H, Komatsuda T, Sato M, et al: Portal thrombosis due to gastrointestinal cancer. Abdom Imaging1999;24:585-590.
5.
5. Belcher H, Beidle T: Evaluation of hepatic vascular abnormalities with Doppler modalities. Appl Radiol1998;27:11-16.
6.
6. Mitraite D, Krimetis A: The possibility of the investigation of portal vein thrombosis by means of ultrasonography. Medicina2002;38:205-209.
7.
7. Novick S, Fishman E: Portal vein thrombosis: Spectrum of helical CT and CT angiographic findings. Abdom Imaging1998;23:505-510.
8.
8. Tublin M, Dodd G, Baron R: Benign and malignant portal vein thrombosis: Differentiation by CT characteristics. AJR1997;168:719-723.
9.
9. Sugiyama M, Hagi H, Atomi Y: Reappraisal of intraoperative ultrasonography for pancreatobillary carcinomas: Assessment of malignant portal venous invasion. Surgery1999;125:160-165.
10.
10. Calculli L, Cassadei R, Amore B, Albin R, Riccioli L, Minni F, et al: The usefulness of spiral CT and color Doppler ultrasonography to predict portal-mesenteric trunk involvement in pancreatic cancer. Radiol Med (Torino)2002;104:307-315.
11.
11. Samel S, Sturn J, Gaa J: CT or MRI for predicting vascular involvement in pancreatic cancer? Pancreatology2002;2:425-426.
12.
12. Smith T, Semelka R, Noone T, Balci NC, Woosley JT: Islet cell tumor of the pancreas associated with tumor thrombus in the portal vein. Magn Reson Imaging1999;17:1093-1096.
13.
13. Asahara T, Itamoto T, Katayama K, Nakahara H, Okamoto V, Hino H, et al: A surgical treated long-term survivor of HCC with tumor thrombi in the trunk of the portal vein. Hiroshima J Med Sci1998;47:157-161.
14.
14. Sugimoto C, Saito A, Kikuzato M, Hayashi N: Angioechographic evaluation of tumor thrombi and the effect of transcatheter arterial embolization in patients with HCC. J Gastroenterol2002;37:363-368.
