Contrast-enhanced sonography versus biopsy for the differential diagnosis of thrombosis in hepatocellular carcinoma patients

Table 1 Enrollment design

Contents
Inclusion criteria	Presence of one to three focal HCC Presence of intra-vascular1 portal vein thrombosis Child-Pugh class A or B
Patients initially enrolled	Men: 190 Women: 66
Excluded for US evidence direct HCC portal vein invasion	70
Drop out on follow-up	78 (42%)
Died	30
Liver could not be adequately visualized	9
Patients studied	Mean age: 66 ± 6 Men: 82 Women: 26

¹Not US features of infiltration of perivascular parenchyma: intact vessel wall.

Table 2 Principal clinical/ultrasound features of patients

Clinical data	Results
Child A/B	44/64
Etiology
HCV related	58
HBV related	23
Alcohol related	12
Mixed etiology	15
Number of HCC nodules
Single nodule	10
Median size	44 mm (range 40-75 mm)
Two nodules	22
Median size	41 mm (range 33-68 mm)
Three nodules	76
Median size	39 mm (range 32-67 mm)
Topography of portal vein thrombosis
In right or left but not in the main portal vein	80 (74%)
In main, right and left portal vein	14 (13%)
In right or left and main portal vein	12 (11%)
In main portal vein	2 (1.8%)
Complete or incomplete vessel occlusion of on power-color-Doppler
A complete occlusion of the portal vessel	99 (91%)
Incomplete thrombosis lumen	9 (9%)

Table 3 Contingent tables

Group	Results
Patients studied on follow-up	108
Malignant thrombosis	58 (53.7%)
Benign thrombosis	50 (46.3%)
Presence of neoplastic cells on PVT FNB1
True positive	52 (48.1%)
False positive	0
Not neoplastic cells on baseline PVT FNB
False negative	62 (5%)
True negative	50 (46.3%)
Iso-hyper-enhancement pattern1 on CEUS and mosaic pattern
True positive	58
Precocious isoenhancement pattern	21
Precocious hyperenhancement pattern	31
Mosaic pattern3	6
False positive	0
Hypoenhancement patternc on CEUS
False negative	0
True negative	50 (46.3%)

Sensitivity, specificity, positive and negative predictive value of CEUS: All 100%.

¹Iso-hyper-hypoenhancement pattern of thrombus respect to surround parenchyma;

²False negative patients on portal vein FNB were the same with mosaic pattern on CEUS;

³Hynomogeneous iso-hyperenhancement of thrombus.