Portal vein evaluation with US: Comparison to angiography combined with CT arterial portography

PURPOSE: To compare ultrasound (US) to angiography combined with computed tomography during arterial portography (CTAP) in the preoperative evaluation of the portal vein. MATERIALS AND METHODS: Sixty-three consecutive patients being considered for hepatic resection underwent color and spectral Doppler US and angiography with CTAP before surgery. The main, right, and left portal veins were evaluated separately. A total of 187 veins were assessed for encasement, occlusion, or thrombosis. RESULTS: At surgery, 41 portal veins were abnormal. US allowed detection of 38 of 41 (93%) involved portal veins with 93% sensitivity, 99% specificity, 97% positive predictive value, and 98% negative predictive value. Angiography with CTAP allowed diagnosis of 37 of 41 (90%) involved portal veins with 90% sensitivity, 99% specificity, 95% positive predictive value, and 97% negative predictive value. CONCLUSION: US is comparable to angiography combined with CTAP in evaluation of the portal vein.