The Role of CT scan In Differentiating between Neoplastic and Benign Portal Vein Thrombosis Using Thrombus Density

Background: Portal vein thrombosis is described as the presence of a clot in the portal vein lumen. It's considered as common complication of chronic liver disease and hepatocellular carcinoma. The aim of this study was to assess the diagnostic value of CT density measurements in differentiating between neoplastic and benign PVT on Triphasic CT studies. Methods: This retrospective study was carried out on thirty patients who presented with ultrasound diagnosis of portal vein thrombosis to the radiology department at National Liver Institute, Menoufiya University, Egypt. Results: Our study showed excellent sensitivity, specificity and accuracy of thrombus density measurements in determining the nature of the portal vein thrombosis at the arterial and portovenous phases on Triphasic CT studies. At the arterial phase, the sensitivity of thrombus density measurements was 100%, the specificity was 93% and the accuracy was100%. At the portovenous phase, the sensitivity of thrombus density measurements was 100%, the specificity was 93% and the accuracy was 100%. The best cut off value of thrombus density at the arterial phase was (45) and at the portovenous phase was (52). Conclusion: Differentiation between benign and neoplastic PVT is very important to determine the strategy of treatment especially for liver transplantation. Triphasic CT is considered a reliable tool for the detection of PVT. CT density measurements can differentiate between neoplastic and benign PVT at the arterial and portovenous phases.