Portal vein cavernous transformation (CTPV) is the result of partial/complete obstruction of the main portal vein and the corresponding increase in portal vein pressure. Atypical symptoms of CTPV include splenomegaly, hypersplenism, ascites, hematemesis, and tarry stools. Currently, the diagnostic criteria for CTPV in China involve occlusion of the portal vein and the presence of more than three blood vessels in its immediate area. As the main method for screening lesions, CT examinations are commonly used, along with ultrasound, computed tomography, magnetic resonance imaging, and digital subtraction angiography. Color Doppler ultrasound examination is widely utilized, leading to a high rate of confirmed diagnoses for this disease, making it the preferred diagnostic approach. On CT, CTPV manifests with disorders in the running area of the portal vein system and the disappearance of the normal portal vein system structure. Multiple collateral circulation veins are intertwined, showing shadows of reticular structures that resemble massive soft tissues. An enhanced scan reveals obvious enhancement of these structures in the portal venous phase, which appears on the cross-section of CT as tortuous and dilated venous vessels. Doppler ultrasound with color is the preferred diagnostic method. It detects only a few continuous colors of blood flow or no signals at all in the main portal veins.