No abstract availalbe.
Carcinoma, Hepatocellular* ; Gastroenterology* ; Portography*

We compared 87 portographic filling defects detected by portal CT in 64 patients were compared with those obtained by indirect portography. The indirect portography could visualize portogram only in anterior-posterior view. But the portal portal CT could visualize both portogram and hepatogram. We examined the portal CT and indirect portography and compared the accuracy of the both methods to evaluate the limitation and significance of the indirect protography. The mass shape lesions were seen on the portal CT which means portal flow defects of the mass lesions only could not depict totally in indirect portography (0%, 0/41). And the larger defects than real mass lesion were seen in portal CT means mass with associated portal flow defect and find portal vein invasion around the mass in 52% (24/46) of the indirect portography. Among them, only 66% of mass were detected correctly in the indirect portography comparing with mass lesion in portal CT. In summary, indirect portogram could not detect small filling defects which detected in portal CT and could not depict the extent of large filling defects. It also could not visualize correctly the protal flow in non-lesion side of the liver parenchyma.
Humans ; Liver ; Portal Vein ; Portography*

PURPOSE: To discribe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. MATERIALS AND METHODS: Four portogramsin five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a cntrol subject with liver cirrhosis. RESULTS: Portographic findings of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. CONCLUSION: A portogram of idiopathic portal hypertension may be useful in differentiating this andliver cirrhosis.
Fibrosis ; Humans ; Hypertension, Portal* ; Liver Cirrhosis ; Portography

A study on branching patterns of middle hepatic artery was performed in 109 patients with A-P and oblique view hepatic angiogram, which refered to size and location of quadrate lobe in CT and SMA portography We could analyze the branching patterns of middle hepatic artery (MHA) in 100 among the 109 patients. MHA arising as a first branch of left hepatic artery was the most common pattern (50%), and MHA arising from proper hepatic artery separately one from left hepatic artery was the next common pattern (35%). MHA originating from left gastric artery, or from anterior or posterior of the right hepatic artery was seen. MHA WAS not found as an accessory or replaced artery except as replaced common hepatic artery.
Angiography* ; Arteries ; Hepatic Artery* ; Humans ; Portography

PURPOSE: Portal branching patterns (ramification) that differ from those previously described are occasionally encountered during liver surgery. We studied the portal vein branching patterns by performing 64 MDCT. METHODS: A total of 100 patients with normal liver underwent MDCT during arterial portography. Next, the 3 dimensional portograms were reconstructed and the portal branching patterns were assessed. RESULTS: In 80 (80%) of the 100 patients we examined, the right anterior portal vein bifurcated into the ventral and dorsal branches. Only 20 percent of the patients showed the classic pattern, that is, bifurcating into the right anterior superior (P8) and right anterior inferior branches (P5). The portal branches in segment 5 showed many variations in their origins and numbers. The portal branches in segment 7 originated from both the right anterior and posterior portal veins, and not just the right posterior portal vein. CONCLUSION: Instead of dividing the right liver into the superior and inferior segments, we proposed that the right liver can be divided into 3 segments, which are designated as the right anterior, middle and posterior segments. In the view of the vascular watershed, the division of the right anterior and posterior sections by using the right hepatic vein might be inaccurate.
Hepatic Veins ; Humans ; Liver ; Portal Vein ; Portography

PURPOSE: To assess the malignant potential of small(< or =15mm) portal defects seen on CT arterial portography,the findings of CT hepatic arteriography and lipiodol CT CT were reviewed. MATERIALS AND METHODS: In 91 patientswho underwent both CTAP and CTHA, small portal defects were re-viewed for frequency, multiplicity and location. Weprospectively evauluated changes in the size and enhance-ment pattern of malignant lesions on follow up CTaccording to density on CTHA, location, lipiodol deposits on lipiodol CT, and multiplicity. RESULTS: Among the 91patients, 102 small defects were defected in 42 patients(46%). Small portal defects were benign, malignant, and ofundetermined malignant potential in 77%, 20% and 3% of cases, respectively. Small portal defects that werehyperattenuated on CTHA, and lipiodol deposits on lipiodol CT, were malignant in 42% and 70% of cases,respectively. Location and multiplicity did not show statistically significant variation between benign andmalignant defects. CONCLUSION: Small portal defects are common and there is a high probability that portaldefects smaller than 15mm are benign, even in patients with a known hepatic mass and defect that washyperattenuated on CTHA. If a small defect showed lipiodol deposit on lipiodol CT, malignancy must be suspected.
Angiography* ; Ethiodized Oil* ; Follow-Up Studies ; Humans ; Liver* ; Portography*

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies

OBJECTIVE: To assess the clinical application of preoperative retrograde portal venography for children with cavernous transformation of the portal vein (CTPV). METHODS: The clinical data of 8 cases of CTPV admitted in the Children's Hospital of Zhejiang University from January 2018 to September 2019 were retrospectively analyzed. Preoperative retrograde portography was performed to determine the corresponding vascular morphology and size of portal vein system. If the retrograde portography showed that the left branch of the shadow portal vein was unobstructed and its diameter was greater than 3 mm, Rex shunt would be performed after anatomic exploration of Rex recess; if retrograde portography showed that the diameter of left portal vein was less than 3 mm, but the diameter of left renal vein dissected during shunt operation was greater than 5 mm, Warren operation was selected. The patients were followed up for 1, 3 and 6 months after discharge, and then were followed up every 6 months. RESULTS: Retrograde portal venography was successfully performed in 8 child patients.The anatomical position and size of main portal vein and its left and right branches, left renal vein and other important vessels were determined. Among them, there was the well-developed left and right branches of portal vein in 4 child patients, in which the left and right branches of portal vein converged together, but did not communicate with the main portal vein. In addition, the left branch diameter of the portal vein was greater than 3 mm, and the anatomical exploration results during shunt were consistent with it, so Rex shunt was performed. In the other 4 cases, the left branch diameter of the portal vein was small (less than 3 mm) in 3 cases, and the right branch was not clearly developed. Moreover, the left branch of the portal vein was poorly developed and almost occluded in 1 case. However, the left renal vein in these 4 child patients was well developed, the blood flow was unobstructed and the diameter was greater than 5 mm, so Warren operation was performed. Seven patients recovered well after the operation, and the other one had digestive tract rudimentary one year after operation, and the condition was stable after conservative treatment. CONCLUSIONS The preoperative retrograde portal venography can be used to evaluate the portal vein system in children with CTPV, which provides important clinical basis for making appropriate treatment plan before surgery.
Child ; Humans ; Portal Vein/surgery* ; Portography ; Retrospective Studies

In portal hypertension, hepatopetal flow is rerouted away from the liver through collateral pathways to low pressure systemic vessels. Information about collateral pathways is relevant, especially when interventional procedure or surgery is contemplated, because inadvertent disruption of these veins can cause significant bleeding. Dynamic CT and spiral CT with a bolus injection of contrast material have to a significant extent recently replaced angiography. The porto-systemic collateral pathways have, however, been classified and described according to location or frequency in a majority of previous reports. This essay illustrates variable porto-systemic collateral blood flow pathways, with CT and angiography correlation.
Angiography* ; Hypertension, Portal* ; Liver ; Portasystemic Shunt, Surgical ; Portography ; Tomography, Spiral Computed ; Veins