Case of the Day: CEUS of the liver.

Case Title: The role of CEUS in portal vein thrombus.

Patient History:

45-y-o male with Hepatitis B cirrhosis, coming for regular liver surveillance ultrasound.

Thanks to:

Contributors:
Christine Merrill
Stephanie R. Wilson
University of Calgary

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IMAGE DESCRIPTION: Greyscale saggital image of the LT lobe of the liver.

QUESTION: The arrows are pointing to?

Liver masses suggestive of metastasis

A tumor mass (yellow arrow) and portal vein thrombus (white arrow)

A Liver infarct (yellow arrow) and a bland thrombus in the portal vein (white arrow)

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IMAGE DESCRIPTION: CEUS Washin- The white arrow is the portal vein; the yellow arrow is on the tumor.

QUESTION: What is the most important enhancement observation?

Both the tumor and the portal vein show enhancement in the arterial phase at 20s

There is no enhancement of the tumor or the portal vein at 10s

There is enhancement in the both the tumor and the portal at 45s

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IMAGE DESCRIPTION: Late phase of the mass (yellow arrow) and Portal vein (white arrow).

QUESTION: What do you notice about both the mass and the portal vein in the late phase?

Hyperenhancement

Washout

Isoenhancement

Your score is

The average score is 42%

0%

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