Background: Liver cirrhosis (LC) is considered the most prevalent cause of portal vein thrombosis (PVT) due to the defective synthetic function of the liver and stagnation of blood flow. The present work aims to assess the impact of shear wave elastography (SWE) in distinguishing between tumoral and bland PVT by using triphasic CT study of the liver as gold standard.

Methods: This prospective cross-sectional study was conducted on 24 cases in Radio-diagnosis Department, Faculty of Medicine, Zagazig University. All patients present with suspected Portal vein thrombosis were subjected to full history and clinical assessment. All cases were conducted to complete history taking, clinical assessment, and laboratory investigations including: Hemoglobin, platelet count, Liver function Test (Albumin, Total bilirubin, ALT, and AST) and Kidney function Test (Blood Urea and S. Creatinine). In addition to radiological assessment including triphasic CT examination of PV with 2 D portography and Shear wave elastography.

Results: There was a significant variance between malignant and benign lesions detected by Triphasic CT as regard age, age group, sex, site of thrombosis, SWE and diagnosis (P=0.02, 0.008, 0.04, 0.04, <0.001 and 0.01, respectively). On conducting ROC curve analysis for discriminating between benign and malignant lesions by shear wave elastography, at cut off point 13, it shows sensitivity (84.2%), specificity (100%) and AUC (0.921).

Conclusion: SWE is able to distinguish between benign and malignant PV thrombus without the need of contrast, radiation or invasive techniques.