Doppler Ultrasound Evaluation of Portal Vein Thrombosis in Cirrhotic Patients with and without Hepatocellular Carcinoma

Abstract

Introduction: Portal vein thrombosis (PVT) is a significant vascular complication in cirrhotic patients, often exacerbated by hepatocellular carcinoma (HCC). Accurate and timely diagnosis of PVT using Doppler ultrasound is crucial to guide clinical management and improve patient outcomes. However, the characteristics and implications of PVT in cirrhotic patients with and without HCC require further exploration.

Objective: This study aimed to evaluate the incidence, characteristics, and diagnostic features of PVT in cirrhotic patients with and without HCC using Doppler ultrasound.

Methodology: A descriptive case-control study was conducted at Sheikh Zayed Hospital, Rahim Yar Khan, over four months. A total of 132 patients were enrolled through convenience sampling. Inclusion criteria encompassed cirrhotic patients with suspected PVT. Doppler ultrasound was employed to assess portal vein diameter, flow velocity, and thrombus characteristics. Data were analyzed using SPSS version 21, with significance set at p ≤ 0.05.

Results: PVT was identified in 59.8% of participants, with 29.5% exhibiting complete and 30.3% partial thrombi. HCC was present in 52.3% of patients and was significantly associated with higher PVT incidence. Doppler ultrasound demonstrated high diagnostic accuracy in differentiating benign from malignant thrombi, supported by specific flow characteristics and thrombus morphology.

Conclusion: Doppler ultrasound is a reliable and non-invasive tool for diagnosing PVT, particularly in cirrhotic patients with HCC. These findings underscore the need for routine Doppler screening in at-risk populations to improve early detection and management outcomes.