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The thread and streak sign of portal vein tumour thrombus demonstrated by colour Doppler imaging

Department of Diagnostic Imaging, St Vincents Hospital, Elm Park, Dublin 4, Ireland

This excerpt was created in the absence of an abstract.

The angiographic, computed tomographic (CT) and real-time ultrasound demonstration of portal vein invasion and tumour thrombus is well documented, particularly in association with hepatocellular carcinoma (Gregg et al, 1975; Miller & Thomas, 1979; Freeny, 1980). One sign of portal vein tumour thrombus is the "thread and streak" sign first described angiographically in 1975 (Okuda et al, 1975). In this paper, we describe an unusual case of portal vein tumour thrombus first suspected by colour Doppler imaging (CDI). There have been no previously documented cases to show the thread and streak sign using this technique.

A 73-year-old man presented with a 4-month history of back pain, anorexia, weight loss and dyspnoea. He had a history of left pneumonectomy for squamous cell carcinoma of the bronchus 12 years previously, and a more recent history of drainage of left empyema 9 months earlier.

Key Words: Portal vein tumour thrombus • Colour Doppler imaging • CT portal venography