THE INCIDENCE, CHARACTERISTICS, MANAGEMENT, PROGNOSIS, AND CLASSIFICATION OF BREAKTHROUGH VITREOUS HEMORRHAGE SECONDARY TO POLYPOIDAL CHOROIDAL VASCULOPATHY.

PURPOSE: To describe breakthrough vitreous hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). METHODS: Patients with the diagnosis of PCV from January 2005 to March 2020 at Peking Union Medical College Hospital were retrospectively reviewed, cases with breakthrough vitreous hemorrhage were analyzed. Subgroup analysis was conducted regarding pachychoroid PCV and nonpachychoroid PCV. RESULTS: Among 722 PCV patients (834 eyes), 103 eyes with breakthrough vitreous hemorrhage (12.4%) were included. Pars plana vitrectomy and proper further interventions could significantly improve the best-corrected visual acuity from logMAR 2.15 ± 0.48 (Snellen 20/2825) to 1.65 ± 0.67 (20/893). Hemorrhagic retinal detachment, baseline central macular thickness, and best-corrected visual acuity were factors associated with final best-corrected visual acuity (P < 0.05). In the pachychoroid PCV group, patients were younger, all had hemorrhagic pigment epithelial detachment, with a higher prevalence of choroidal vascular hyperpermeability and hemorrhagic retinal detachment, thicker subfoveal choroidal thickness, and thinner central macular thickness; besides, the initial pars plana vitrectomy were more complicated, more additional surgeries had to be performed. More eyes in the nonpachychoroid PCV group had received anti-vascular endothelial growth factor or photodynamic therapy, mostly fibrovascular pigment epithelial detachment, the best-corrected visual acuity and the status of the fellow eye were significantly worse. For the final ocular status, more eyes in nonpachychoroid PCV group were taking anti-vascular endothelial growth factor monotherapy, whereas more eyes in pachychoroid PCV group were stable. The choroidal parameters of these two groups were all significantly different. CONCLUSION: Breakthrough vitreous hemorrhage is a troublesome complication of PCV. Pars plana vitrectomy and additional interventions are required for better prognosis. Vitreous hemorrhage secondary to pachychoroid PCV or nonpachychoroid PCV have different characteristics and prognosis.

Comparison of OCT and OCTA manifestations among untreated PCV, neovascular AMD, and CSC in Chinese population.

AIM: To compare the qualitative and quantitative features among untreated polypoidal choroidal vasculopathy (PCV), neovascular age-related macular degeneration (nv-AMD) and central serous chorioretinopathy (CSC) using optical coherence tomography (OCT) and OCT angiography (OCTA). METHODS: This retrospective study included 16 eyes with thin-choroid PCV, 18 eyes with thick-choroid PCV, 16 eyes with nv-AMD and 17 eyes with CSC, respectively. The indicators were obtained by OCT and OCTA. RESULTS: Sub-foveal choroidal thickness (SFCT) in CSC was thicker compared to other groups (all P<0.05). SFCT in nv-AMD was thicker compared to thin-choroid PCV, but thinner compared with thick-choroid PCV (both P<0.05). As the ratio of thickness of Haller's layer to thickness of SFCT, which of thin-choroid PCV was significantly higher than CSC (P<0.001). Likewise, thick-choroid PCV had significantly higher ratio than nv-AMD (P=0.016) or CSC (P<0.001). There were differences among them in pigment epithelium detachment (PED). The whole-superficial retinal vessel density (RVD), deep RVD and choroidal capillary vessel density (CCVD) in CSC were significantly higher compared to other three groups, respectively (all P<0.05). The whole CCVD in nv-AMD was higher compared to thick-choroid PCV (P=0.032). Cross-sectional local angiographic form was 87.50%, 83.33%, 0 and 35.29% in thin-choroid PCV, thick-choroid PCV, nv-AMD and CSC, respectively. Cross-sectional diffuse angiographic form was 12.50%, 16.67%, 100% and 5.88% in thin-choroid PCV, thick-choroid PCV, nv-AMD and CSC, respectively. CONCLUSION: Combination of OCT and OCTA can effectively observe the significant alterations existed in PCV, CSC and nv-AMD, and there are distinctive differences among them. The pathogenesis is not exactly the same between PCV and nv-AMD, or PCV and CSC.

THE OCCURRENCE, CHARACTERISTICS, MANAGEMENT, AND PROGNOSIS OF RETINAL PIGMENT EPITHELIUM TEARS IN PATIENTS WITH POLYPOIDAL CHOROIDAL VASCULOPATHY: A Retrospective Study of 397 Patients.

PURPOSE: To investigate retinal pigment epithelium (RPE) tears in patients with polypoidal choroidal vasculopathy. METHOD: A retrospective review of polypoidal choroidal vasculopathy cases with confirmed RPE tears was conducted. Patients' comprehensive clinical data were collected and analyzed. The treatment strategy was a loading dose of one intravitreal antivascular endothelial growth factor injection, combined with additional injections if exudative activities or visual deterioration were detected. RESULTS: Among 397 polypoidal choroidal vasculopathy patients, 33 patients with RPE tears (8.3%) were included. 42.4% of them happened spontaneously. Pigment epithelial detachment (PED) occurred more frequently in RPE tear patients and most of them had serous vascularized or hemorrhagic PED. The height and greatest linear diameter of PED, and the subfoveal choroidal thickness of these cases were significantly larger, whereas the central foveal thickness was significantly smaller. Most of the RPE tears occurred at the edge of the PED. After our treatment strategy, patients' best-corrected visual acuity improved significantly from 2.13 ± 1.24 (median 20/52) to 1.32 ± 1.31 (median 20/166). Large subretinal hemorrhage may increase the risk of the formation of subretinal fibrosis (P < 0.05). CONCLUSION: Retinal pigment epithelium tears in polypoidal choroidal vasculopathy are associated with high subRPE hydrostatic pressure, produced by a large PED or hemorrhage. After our intervention strategy, this condition may not necessarily result in poor prognosis.

Analysis of the antimicrobial activity of Lactobacillus plantarum YM-4-3: implications of suitable conditions for extending the shelf life of fermented soybean products.

Lactobacillus (Lb.) plantarum is typically used as a starter culture in salt-fermented foods. Here we report 3-4% NaCl reducing the antimicrobial activity of Lb. plantarum strain YM-4-3, owing to the decrease of bacterial growth, plantaricin activity and expression levels of plantaricin biosynthesis-related genes (PBGs). Meanwhile, 1% NaCl promoted slightly the growth of YM-4-3 and up-regulated the expression of PBGs to the greatest level. The results from a spoilage experiment of fermented soybean products revealed that the 1% NaCl and YM-4-3 treatment group had the longest shelf life representing the minimum number of pathogenic bacteria and the lowest degree of mildew. Therefore, a combination of Lb. plantarum with a low concentration of salt, such as 1% NaCl, is a recommended condition for preparing fermented foods.

Dendrocoumarin: a new benzocoumarin derivative from the stem of Dendrobium nobile.

A new benzocoumarin derivative, dendrocoumarin (1), along with itolide A were isolated from the stems of Dendrobium nobile. The structure of the new compound 1 elucidated on the basis of NMR and mass spectroscopic data. Compounds 1 and 2 showed broad spectrum antibacterial activity against five terrestrial pathogenic bacteria.

Pilot study on efficacy of reduced cathartic bowel preparation with polyethylene glycol and bisacodyl.

AIM: To evaluate the efficacy of reduced cathartic bowel preparation with 2 L polyethylene glycol (PEG)-4000 electrolyte solution and 10 mg bisacodyl enteric-coated tablets for computed tomographic colonography (CTC). METHODS: Sixty subjects who gave informed consent were randomly assigned to study group A, study group B or the control group. On the day prior to CTC, subjects in study group A were given 20 mL 40% wt/vol barium sulfate suspension before 3 mealtimes, 60 mL 60% diatrizoate meglumine diluted in 250 mL water after supper, and 10 mg bisacodyl enteric-coated tablets 1 h before oral administration of 2 L PEG-4000 electrolyte solution. Subjects in study group B were treated identically to those in study group A, with the exception of bisacodyl which was given 1 h after oral PEG-4000. Subjects in the control group were managed using the same strategy as the subjects in study group A, but without administration of bisacodyl. Residual stool and fluid scores, the attenuation value of residual fluid, and discomfort during bowel preparation in the three groups were analyzed statistically. RESULTS: The mean scores for residual stool and fluid in study group A were lower than those in study group B, but the differences were not statistically significant. Subjects in study group A showed greater stool and fluid cleansing ability than the subjects in study group B. The mean scores for residual stool and fluid in study groups A and B were lower than those in the control group, and were significantly different. There was no significant difference in the mean attenuation value of residual fluid between study group A, study group B and the control group. The total discomfort index during bowel preparation was 46, 45 and 45 in the three groups, respectively, with no significant difference. CONCLUSION: Administration of 10 mg bisacodyl enteric-coated tablets prior to or after oral administration of 2 L PEG-4000 electrolyte solution enhances stool and fluid cleansing ability, and has no impact on the attenuation value of residual fluid or the discomfort index. The former is an excellent alternative for CTC colorectum cleansing.

Preliminary study on MR colonography with air enema in detection of colorectal neoplasms.

BACKGROUND: The few studies on MR colonography with air enema involved feasibility of bowel distention and imaging quality and lacked detection sensitivity of colorectal neoplasms. The purpose of this prospective study was to assess the detection sensitivity of colorectal neoplasms with the three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema. METHODS: A total of 30 patients scheduled for optical colonoscopy due to rectal bleeding, positive fecal occult blood test results or altered bowel habits were recruited and successfully underwent entire colorectal examinations with three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography and subsequent optical colonoscopy on the same day. Detection sensitivity of colorectal neoplasms with MR colonography was statistically analyzed on a per-neoplasm size basis by using findings from optical colonoscopy and histopathological examinations as the reference standards. RESULTS: Seventy-six neoplasms were detected with optical colonoscopy, consisting of 1 mm-5 mm (n = 11), 6 mm-9 mm (n = 29) and ≥ 10 mm (n = 36) in diameter. Detection sensitivities of 1 mm-5 mm, 6 mm-9 mm, ≥ 10 mm and ≥ 6 mm colorectal neoplasms with MR colonography were 9.1%, 75.9%, 100% and 89.2%, respectively; overall detection sensitivity for all sizes colorectal neoplasms was 77.6%. CONCLUSIONS: Detection sensitivity of three-dimensional Fourier transform fast spoiled gradient-recalled MR colonography with air enema is low for 1 mm-5 mm colorectal neoplasms, but the detection sensitivity is 89.2% for ≥ 6 mm neoplasms, and all ≥ 10 mm neoplasms could be detected.

Deepgoing study on intrathoracic tuberculous lymphadenitis in adults using multidetector CT.

BACKGROUND: Studies on intrathoracic tuberculous lymphadenitis in adults are confined to the preliminary CT findings with ordinary CT and ordinary spiral CT. There has been no deepgoing study of multidetector CT to date. Multidetector CT could contribute to better imaging of intrathoracic tuberculous lymphadenitis in adults. The purpose of this study was to explore the multidetector CT features of intrathoracic tuberculous lymphadenitis in adults, and the correlation with clinical symptoms and pathologic changes. METHODS: Multidetector CT findings from 42 consecutive adult patients with intrathoracic tuberculous lymphadenitis were analyzed retrospectively with regard to locations, sizes, numbers, shapes, margins, and densities reviewing precontrast and enhanced images. CT results were correlated with clinical symptoms and pathologic results (n = 37). RESULTS: One hundred and eighty-five intrathoracic lymph nodes that had tuberculous lymphadenitis in 42 patients were distributed mainly in regions 4R (n = 37), 2R (n = 33), 7 (n = 31) and 10R (n = 21), more than 2 regions were implicated in 34 patients. One hundred and twenty-two (72.2%) of the tuberculous lymphadenitis without confluence were oval or round with clear margins. On precontrast scanning, 78.4% of tuberculous lymphadenitis had a homogeneous density. Seven enhancement patterns were demonstrated in 169 tuberculous lymphadenitis from 37 patients with pathologic results: homogeneous enhancement with no clinical symptom (n = 12), corresponded pathologically to tuberculous hyperplasia without caseous necrosis; heterogeneous enhancement with a small central no enhancement area, slight clinical symptoms (n = 22), tuberculous granulomas with a little caseous necroses; peripheral irregular thick wall enhancement with a central area with no enhancement, slight clinical symptoms (n = 52), tuberculous granulomas with some caseous necroses in the center; peripheral thin rim enhancement with a central area having no enhancement, moderate clinical symptoms (n = 36), a few tuberculous granulomas with a great quantity of caseous necroses in the center; peripheral irregular enhancement without central enhancement, extending outside the capsule, severe clinical symptoms (n = 4), caseous necroses ruptured from capsule; peripheral irregular rim enhancement with central separate enhancement, severe clinical symptoms (n = 40), multiple lymph nodes with liquefaction of caseous necroses were adherent and confluent, rim and separation were tuberculous granulomas; no obvious enhancement, severe clinical symptoms (n = 3). Caseous necrosis was usually associated with little tuberculous granulomas. CONCLUSIONS: The main multidetector CT features of intrathoracic tuberculous lymphadenitis in adults are involvement of multiregional lymph nodes with oval or round shape and clear margins, a basically homogeneous density on precontrast scanning, multiple enhancement patterns, and they correlate closely with clinical symptoms. Multidetector CT could reveal pathological changes of intrathoracic tuberculous lymphadenitis in adults.

Clinical features, laboratory findings and imaging appearances of venous diethylene glycol poisoning in patients with liver disease.

BACKGROUND: There was a hospital outbreak of venous diethylene glycol poisoning in Guangzhou, China. It is the only massive episode of venous diethylene glycol poisoning in history. Here we report its clinical features, laboratory findings, and imaging appearances. METHODS: The clinical features of 15 venous diethylene glycol poisoning patients with liver disease were analyzed and summarized. Their laboratory findings and imaging appearances were comparatively analyzed before and after poisoning. RESULTS: All poisoned patients presented with oliguric acute renal failure with anuria after a mean of 6 days. Carbon dioxide combination power of 13 patients dropped after a mean of 9 days with valley value on the 10th day, when metabolic acidosis developed. Gastroenteric symptoms or aggravation of gastroenteric symptoms were displayed in 11 patients after a mean of 9 days. Neurological system impairment was observed in 10 patients after a mean of 14 days. Seven patients had low fever after a mean of 6 days. Causes of death of 14 patients included multiple organ dysfunction syndrome, severe lung infection and massive haemorrhage of digestive tract. Blood creatinine and urea nitrogen were abnormal after a mean of 5 days with peak value on the 11th and 14th days, respectively. Serum calcium had no obvious change, and phosphorus was distinctively increased. Liver functions did not change significantly. Poisoned patients had higher white blood cell counts, but lower red blood cell counts and hemoglobin value. Of the 7 patients who exhibited mild, moderate or severe patchy consolidation shadowing in the lung, 2 manifested mild or severe gaseous distention and dilation of gastroenteric tract. CONCLUSIONS: Main features of venous diethylene glycol poisoning in patients with liver disease include oliguric acute renal failure, metabolic acidosis, gastroenteric symptoms or aggravation of gastroenteric symptoms, neurological system impairment and low fever, with a mortality rate of 93.33% in poisoned patients. There is also higher white blood cell counts and anemia, patchy consolidation shadowing in the lung, gaseous distention and dilation of gastroenteric tract, which occurs later than mild patchy consolidation shadowing and earlier than moderate patchy consolidation shadowing in the lung.

[Clinical features, laboratory findings and imaging appearances of venous diethylene glycol poisoning in patients with liver disease].

OBJECTIVE: To summarize and report the clinical features, laboratory findings and imaging appearances of venous diethylene glycol poisoning in patients with liver disease. METHODS: The clinical features of 15 venous diethylene glycol poisoning patients with liver disease were analyzed and summarized, their laboratory findings and imaging appearances were comparative analyzed before and after poisoning. RESULTS: All poisoned patients presented oliguric acute renal failure with anuria after a mean of 6 days. Carbon dioxide combination power of 13 patients was dropped after a mean of 9 days with trough value at the 10th day, and metabolic acidosis was developed. Gastroenteric symptoms or aggravation of gastroenteric symptoms were displayed in 11 patients after a mean of 9 days. Neurological system impairment was observed in 10 patients after a mean of 14 days. Seven patients had low fever after a mean of 6 days. Causes of death of 14 patients included multiple organ dysfunction syndrome, severe lung infection and massive haemorrhage of digestive tract. Blood creatinine and urea nitrogen were abnormal after a mean of 5 days with peak value at the 11th and 14th days respectively. Serum calcium had no obvious change, and phosphorus was increased distinctly. Liver functions did not change significantly. Poisoned patients had higher white blood cell counts, lower red blood cell counts and hemoglobin value. Of the 7 patients exhibited mild, moderate and severe patchy consolidation shadowing in the lung, 2 manifested mild or severe gaseous distention and dilation of gastroenteric tract. CONCLUSION: Main features of venous diethylene glycol poisoning in patients with liver disease include oliguric acute renal failure, metabolic acidosis, gastroenteric symptoms or aggravation of gastroenteric symptoms, neurological system impairment and low fever, with a mortality of 93.33% of poisoned patients; higher white blood cell counts and anemia; patchy consolidation shadowing in the lung; gaseous distention and dilation of gastroenteric tract, which occures later than mild patchy consolidation shadowing and earlier than moderate patchy consolidation shadowing do in the lung.

Capability of multidetector CT to diagnose hepatocellular carcinoma-associated arterioportal shunt.

AIM: To investigate the capability of multidetector CT (MDCT) to diagnose HCC-associated arterioportal shunt (APS). METHODS: Two hundred and eighty-two patients with HCC received both thin-slice and enhancement MDCT scanning at early hepatic arterial phase, late hepatic arterial phase and portal venous phase, and digital subtract angiography (DSA) examination. Images were analyzed jointly by two experienced radiologists blinded to the opposite examination results, including the existence or not of APS, shunt locations, types and degrees of APS, with or without thrombosis. RESULTS: There were 56 APS associated with HCC, including 48 central, seven peripheral and one mixed, or 42 severe, seven moderate, seven mild APS. Forty-one severe, seven moderate and central APS were all revealed with MDCT and DSA. Seven mild and peripheral APS were all displayed with MDCT; only five of them displayed DSA, two faint shunt APS associated with massive HCC were missed. One mixed APS was demonstrated as severe combined with mild shunt with both MDCT and DSA. CONCLUSION: MDCT could diagnose not only DSA revealed APS, but also missed mild and peripheral APS with DSA due to faint shunt associated with massive HCC, is a simple, effective and noninvasive new technique for diagnosis of HCC-associated APS.

[Diagnostic capability of multidetector CT for arterioportal shunt in hepatocellular carcinoma].

OBJECTIVE: To evaluate the capability of multidetector CT (MDCT) for the diagnosis of arterioportal shunt (APS) associated with hepatocellular carcinoma (HCC). METHODS: Two hundred and eighty-two patients with HCC were examined by both enhanced thin slice MDCT scanning in early hepatic arterial phase, late hepatic arterial phase, portal venous phase and digital subtraction angiography (DSA). The criteria for diagnosis of APS: (1) Earlier enhancement or stronger opacification of main portal trunk and/or the first order branches compared with that of superior mesenteric vein or splenic vein; (2) Earlier enhancement or stronger opacification of the second order and smaller portal venous branches compared with that of main portal trunk. The presence and degree of APS demonstrated with MDCT and DSA were analysed by double blind method. RESULTS: In 282 HCC patients, 56 were complicated with APS. MDCT demonstrated central APS in 48 patients with 41 severe and 7 moderate shunt, one revealing no APS by DSA due to the giant HCC focus. Among 7 patients with light peripheral APS, two lesions were not revealed by DSA due to faint shunt and the last lesion in the patient with mixed APS was revealed both by APS and DSA. CONCLUSION: Multidetector CT was a simple, effective and noninvasive new technique for the diagnosis of arterioportal shunt associated with hepatocellular carcinoma.

[Multidetector spiral CT findings of arteriovenous fistula associated with hepatocellular carcinoma].

BACKGROUND & OBJECTIVE: In clinical practice, a large number of patients might not undergo transcatheter hepatic angiography as a routine examination, which resulted in missed diagnosis of arteriovenous fistula (AVF) associated with hepatocellular carcinoma (HCC) and loss of embolism opportunity. The study was designed to investigate multidetector spiral CT (MDSCT) findings of AVF associated with HCC, so as to improve its diagnosis and differential diagnosis. METHODS: Thin-slice and dynamic enhancement MDSCT findings of AVF proved by digital subtraction angiography of 56 patients with HCC were analyzed. RESULTS: MDSCT demonstrated earlier enhancement of main portal trunks and/or the first order branches than superior mesenteric veins or spleen veins (n=31), 1 patient had early enhancement and strong enhancement of left hepatic vein with thromboses in it and upper part of inferior vena cava, 1 patient had transient patchy enhancement peripheral to HCC focus in late hepatic arterial phase and became isoattenuation at portal vein phase among them; stronger opacification of main portal trunks and/or the first order branches than superior mesenteric veins or spleen veins (n=18); earlier enhancement of the second order branches and smaller of portal veins than main portal trunks (n=4), stronger opacification of the second order branches and smaller of portal veins than main portal trunks (n=3), accompanying with transient patchy enhancement (n=3) or wedge-shaped enhancement (n=4) peripheral to HCC foci at late hepatic arterial phase and became isoattenuation at portal vein phase. Enhancement degrees of HCC foci and spleens were all decreased, and enhancement degrees of liver parenchyma without HCC foci were increased and heterogeneous in 49 patients with severe or moderate and central AVF. CONCLUSION: There are complex MDSCT findings of AVF associated with HCC, and its main manifestations are earlier enhancement and stronger opacification of portal veins and/or hepatic veins.

Postprocessing techniques of CT colonography in detection of colorectal carcinoma.

AIM: To evaluate the value of postprocessing techniques of CT colonography, including multiplanar reformation (MPR), virtual colonoscopy (VC), shaded surface display (SSD) and Raysum, in detection of colorectal carcinomas. METHODS: Sixty-four patients with colorectal carcinoma underwent volume scanning with spiral CT. MPR, VC, SSD and Raysum images were obtained by using four kinds of postprocessing techniques in workstation. The results were comparatively analyzed according to circumferential extent, lesion length and pathology pattern of colorectal carcinomas. All diagnoses were proved pathologically and surgically. RESULTS: The accuracy of circumferential extent of colorectal carcinoma determined by MPR, VC, SSD and Raysum was 100.0%, 82.8%, 79.7% and 79.7%, respectively. There was a significant statistical difference between MPR and VC. The consistent rate of lesion length was 89.1%, 76.6%, 95.3% and 100.0%, respectively. There was a statistical difference between VC and SSD. The accuracy of discriminating pathology pattern was 81.3%, 92.2%, 71.9% and 71.9%, respectively. There was a statistical difference between VC and SSD. MPR could determine accurately the circumference of colorectal carcinoma, Raysum could determine the length of lesion more precisely than SSD, VC was helpful in discriminating pathology patterns. CONCLUSION: MPR, VC, SSD and Raysum have advantage and disadvantage in detection of colorectal carcinoma, use of these methods in combination can disclose the lesion more accurately.

Study on hepatocellular carcinoma-associated hepatic arteriovenous shunt using multidetector CT.

AIM: To investigate multidetector CT (MDCT) findings of hepatocelluar carcinoma (HCC)- associated hepatic arteriovenous shunt (HAVS) and to evaluate their clinical significance. METHODS: Thin-slice and dynamic enhancement MDCT of HAVS was performed on 56 patients with HCC. MDCT findings, including those of portal veins, hepatic veins, superior mesenteric veins, splenic veins, HCC foci, liver parenchyma without HCC foci, spleens, and thromboses in portal veins and hepatic veins, were all confirmed by digital subtract angiography and analyzed. RESULTS: MDCT demonstrated earlier enhancement of main portal trunks and/or the first order branches than that of superior mesenteric veins or splenic veins (n=31). One patient had strong early enhancement of left hepatic vein with thromboses in left hepatic vein and upper part of inferior vena cava and 1 patient had transient patchy enhancement peripheral to HCC foci in late hepatic arterial phase among them. It demonstrated stronger opacification of main portal trunks and/or the first order branches than that of superior mesenteric veins or splenic veins (n=18), and earlier enhancement of the second order and smaller branches of portal veins than that of main portal trunks (n=4), stronger opacification of the second order and smaller branches of portal veins than that of main portal trunks (n=3), with transient patchy enhancement (n=3) or wedge-shaped enhancement (n=4) peripheral to HCC foci in late hepatic arterial phase. Enhancement degree of HCC foci was all decreased. As for 49 patients with severe or moderate shunts, enhancement degree of liver parenchyma without HCC foci was increased with heterogeneous density, but enhancement degree of spleens was decreased. There were thromboses in main portal trunks and/or the first order branches in 32 patients. CONCLUSION: The main MDCT findings of HCC-associated HAVS are earlier enhancement and stronger opacification of portal veins and/or hepatic veins. Understanding of these findings will contribute to the diagnosis and prognosis of the disease and improve therapy for the patients.