Abstract: Objective:To investigate the clinical significance and the image types of ultrasound of hepatocellular carcinoma(HCC) with portal vein tumor thrombus(PVTT) and portal vein blood thrombus(PVBT). Methods:HCC with PVTT of 32 cases(PVTT group) and HCC with PVBT of 18 cases(PVBT group) by transcantheter hepatic arterial chemo-embolization(THAE) were reported. Thirtytwo cases in PVTT group and 4 cases in PVBT group were treated with ultrasound-guided percutaneous portal pathway. The hepatic arteio-venous fistula in the two groups was excluded. Results:According to the image classification of ultrasound,in PVTT group,there were including the type of complete obstruction of the portal vein lumen(n=17),the type of incomplete obstruction(n=6) and the type of invasion the portal wall(n=9). In PVBT group,there were including the type of complete obstruction of the portal vein lumen (10 cases) and the type of incomplete obstruction (8 cases). In PVTT group, the blood supply was revealed in 29 cases by the ultrasound examination while in PVBT group,only one case was with uncertainly blood supply,there was a highly significant difference about the blood supply between PVTT and PVBT group(χ²=38.11,P<0.01). Conclusions:It has a great value in clinical application of the image classification of ultrasonic findings about portal vein thrombus and PVTT.