Ultrasonographic diagnosis of portal cavernoma in children: a study of twelve cases.

Portal vein and its two branches were evaluated by ultrasound in 12 children (14 months to eight years) with portal cavernomas; the cavernomas appeared idiopathic (five cases) or were secondary either to a catherization of umbilical vein in the neonatal period (six cases) or to trauma (one case). Angiographic confirmation of cavernoma was obtained in all patients. Twelve patients with intrahepatic portal hypertension were used as controls. The following abnormal patterns were observed: (1) absence of normal portal vein; (2) absence of normal portal division; (3) tortuous, small and irregular appearance and/or abnormal sagittal division of the venous system; (4) presence of small linear echoes dotting the portal vein; (5) presence of small linear echoes dotting the porta hepatis area. Ultrasonogram was normal in the 12 controls. Thus, ultrasound appears to be a procedure of choice in the evaluation of portal cavernomas, permitting postponement of invasive angiographic examination until surgical treatment is anticipated.