Role of diffusion-weighted MR imaging in differentiation between malignant and benign portal vein thrombosis in patients with Hepatocellular carcinoma

Abstract

Differentiation between malignant and bland thrombus of the portal vein in patients who have HCC using diffusion weighted MR imaging. Objective: To determine the role of DW imaging in differentiating between the benign and malignant portal vein thrombosis in patient with HCC. Patients and Methods: This is a retrospective study done in ain-shams hospitals and private centers. This is a retrospective study done in Ain-Shams Hospitals and private centers. We studied 20 cases, 13 males and 7 females with total mean age 59.5. Results: Our study had some limitations. First, we did not use pathologic findings as our reference standard for characterizing the thrombi; instead, we have used accepted imaging criteria as a reference standard. In our study, we used oval ROI placement and although we avoided averaging ADC of the thrombus with the surrounding structures “by enlarging the images and placing the ROI within the thrombus “, we cannot completely exclude that some averaging could have occurred in the smallest thrombi. Conclusion: In addition to the initial diagnosis of the PVT nature, subsequent contrast-enhanced MRI is actually necessary to evaluate further treatment response in daily routine. But the administration of I.V. contrast agent is problematic especially in patients with renal insufficiency. Therefore, DWI technique can be utilized in adjunction with routine MRI protocols to determine the nature of PVTs by the calculation of ADCs values.