Objective To investigate the reason why idiopathic portal hypertension(IPH) was misdiagnosed as cirrhosis with portal hypertension.Methods 6 cases of IPH were retrospectively analyzed,all of which were misdiagnosed clinically as cirrhosis with portal hypertension but confirmed as IPH by pathology.And comparatively study with 10 cases pathologically proven cirrhosis were also undergone.Results In 6 cases of IPH patients,CHE was above 4 400 U/L and PTA over 80% in 5 cases(5/6);Pathological fidings showed no pseudolobules.Conclusion Imaging findings of IPH is similar with cirrhosis,but the degree of portal hypertension and pathologic damage are milder than patients with cirrhosis;CHE over 4 400 U/L and PTA over 80% can be used as differential indicators.Pathological detection is essential to exclude liver cirrhosis while diagnosing IPH.