Portal vein tumor thrombus (PVTT) is a critical prognostic factor in advanced hepatocellular carcinoma, significantly impacting patient outcomes. Effective management of PVTT is essential for improving survival rates. Current treatment strategies, including vascular interventional therapy, particle implantation therapy, external beam radiotherapy, targeted therapy and immunotherapy, have shown promising outcomes in managing PVTT. Therefore, a thorough understanding of the blood supply to PVTT is crucial for optimizing diagnostic and therapeutic approaches in clinical practice. This review focuses on the establishment and characteristics of PVTT blood supply and its imaging manifestations across various modalities.

Portal vein tumor thrombus (PVTT) is a critical prognostic factor in advanced hepatocellular carcinoma, significantly impacting patient outcomes. Effective management of PVTT is essential for improving survival rates. Current treatment strategies, including vascular interventional therapy, particle implantation therapy, external beam radiotherapy, targeted therapy and immunotherapy, have shown promising outcomes in managing PVTT. Therefore, a thorough understanding of the blood supply to PVTT is crucial for optimizing diagnostic and therapeutic approaches in clinical practice. This review focuses on the establishment and characteristics of PVTT blood supply and its imaging manifestations across various modalities.