Extraction and enhancement of tubular structures are important in image processing applications, especially in the analysis of liver CT scans where delineation of vascular structures is needed for surgical planning. Portal vein cross-sections have circular or elliptical shapes, so an algorithm must accommodate both. A vessel segmentation method based on medial-axis points was developed and tested on portal veins in CT images. A medial-axis enhancement filter was developed. Consider a line passing through a point inside a tube and intersecting the edges of the tube. If the point is located on the medial axis, the distance of the point in the direction of the line to the edges of the tube will be equal. This feature was employed in a multi-scale framework to identify liver vessels. Dynamic thresholding was used to reduce noise sensitivity. The isotropic coefficient introduced by Pock etal. was used to reduce the response of the filter for asymmetric cross-sections. Quantitative and qualitative evaluation of the proposed method were performed using both 2D/3D and synthetic/clinical datasets. Compared to other methods for medial-axis enhancement, our method produces better results in low-resolution CT images. Detection rate of the medial axis by the proposed method in a noisy image of standard deviation equal to 0.3 is 68% higher than prior methods. A new Hessian-based method for medial axis vessel segmentation was developed and tested. This method produced superior results compared to prior methods. This new method has the potential for many applications of medial-axis enhancement.