Objective To evaluate the usefulness of balloon-occluded retrograde transvenous obliteration(B-RTO)in treating varices of gastric fundus.Methods Total 11 patients with liver cirrhosis-combined gastric varices were treated by B-RTO.Transfemoral approach was used in all cases.A balloon catheter was inserted into left adrenal vein,then sclerosing material(5% ethanolamine oleate)was injected into the gastric varices via a gastrorenal shunt with the balloon inflated,the balloon was kept in place for 60 minutes.Follow-up was made by enhanced CT and endoscopy.Results 9 varices of the 11 were disappeared or remarkably decreased in size,and no recurrence or rupture was found during the follow-up period(2-12 months).1 of the remaining two varices decreased after second B-RTO procedure.No definitive change of liver or renal function was noted.Conclusion B-RTO is effective,reliable and less invasive for the treatment of gastric varices.

Objective To evaluate the relationship between the volume of spleen and zebra enhancement pattern on CTAP(CT arterial portography).Methods Total 219 cases of hepatocellular carcinoma underwent CTAP were retrospectively analyzed.The patients were divided into three groups according to the CTAP enhancement patterns:group l,patchy heterogeneous enhancement(zebra pattern);group 2,homogeneous enhancement with remarkable hypodensity of the liver parenchyma(hypodensity pattern);group 3,homogeneous enhancement with definitive contrast(normal pattern).The volume of spleen was measured based on CT findings and compared among the groups.Results In the total 219 cases,there were 10 cases showing zebra enhancement pattern(4.6%),16 cases of homogeneous hypodensity(7.3%)and 193 of normal enhancement pattern(88.1%).The average volumes of the spleen of the three groups were (588.3?331.5) cm 3,(883.2?296.5) cm 3 and (474.4?275.0) cm 3,respectively.There was no significant difference of the splenic volume between groups 1 and 3,and the difference between groups 2 and 3 was significant.Conclusion There is no definitive relationship between the zebra enhancement pattern on CTAP and the volume of spleen,while the homogeneous hypodense enhancement is positively and significantly correlated with the volume of spleen.