Discrepant imaging findings of portal vein thrombosis with dynamic computed tomography and computed tomography during arterial portography in hepatocellular carcinoma: possible cause leading to inappropriate treatment selection

We encountered a patient with hepatocellular carcinoma who had discrepant imaging findings on portal vein thrombosis with portal phase dynamic computed tomography (CT) and CT during arterial portography (CTAP). CTAP, via the superior mesenteric artery and via the splenic artery, both showed a portal...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2017-04, Vol.10 (2), p.163-167
Main Authors: Toyoda, Hidenori, Kumada, Takashi, Tada, Toshifumi, Mizuno, Kazuyuki, Kobayashi, Natsuko, Inukai, Yosuke, Takeda, Akira, Sone, Yasuhiro
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - therapy
Case Report
Chemoembolization, Therapeutic - adverse effects
Chemoembolization, Therapeutic - methods
Colorectal Surgery
Diagnostic Errors
Female
Gastroenterology
Hepatology
Humans
Liver Neoplasms - complications
Liver Neoplasms - therapy
Medicine
Medicine & Public Health
Portal Vein - diagnostic imaging
Portography
Reproducibility of Results
Surgical Oncology
Tomography, X-Ray Computed
Ultrasonography
Venous Thrombosis - diagnostic imaging
Venous Thrombosis - etiology
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Summary:We encountered a patient with hepatocellular carcinoma who had discrepant imaging findings on portal vein thrombosis with portal phase dynamic computed tomography (CT) and CT during arterial portography (CTAP). CTAP, via the superior mesenteric artery and via the splenic artery, both showed a portal perfusion defect in the right hepatic lobe, indicating portal vein thrombosis in the main trunk of the right portal vein. Portal phase dynamic CT clearly depicted portal perfusion of the same hepatic area. Transarterial chemoembolization was successfully performed, but it was associated with severe liver injury. Clinicians should be cautious about this possible discrepancy based on imaging technique. The inaccurate evaluation of portal vein thrombosis may result in inappropriate treatment selection, which can worsen patient prognosis.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-017-0717-4