1.Oblique coronal position-maximum intensity projection and volume rendering reconstructed CT portal vein angiography for diagnosing spleen/stomach-left kidney shunt
Lin DENG ; Ping LIANG ; Zhongkui HUANG ; Dingjiao ZHU ; Gengrui CHEN
Chinese Journal of Interventional Imaging and Therapy 2025;22(1):32-36
Objective To explore the value of oblique coronal position-maximum intensity projection(OC-MIP)and volume rendering(VR)reconstructed CT portal vein angiography(CTPA)for diagnosing spleen/stomach-left kidney shunt(S/sLKS).Methods A total of 62 patients with decompensated liver cirrhosis who underwent TIPS were retrospectively collected.Based on pre-TIPS enhanced portal vein stage CT,CTPA was reconstructed with OC-MIP and VR technology to diagnose S/sLKS and judging the types.Taken digital subtraction angiography(DSA)findings during TIPS treatment as standards,the efficacy of OC-MIP or VR images for diagnosing S/sLKS were evaluated,and their consistency with DSA for diagnosing S/sLKS were evaluated.Results DSA showed S/sLKS in 14 cases(14/62,22.58%),while no S/sLKS in 48 cases(48/62,77.42%).The sensitivity,specificity and accuracy of OC-MIP and VR images for diagnosing S/sLKS were all consistent,which was 92.86%(13/14),95.83%(46/48)and 95.16%(59/62),respectively.OC-MIP and VR images diagnosed S/sLKS were both consistent with that of DSA(both Kappa=0.865).Among 14 cases of S/sLKS,DSA showed spleen-renal shunt(SRS)and gastro-renal shunt(GRS)each in 1 case(1/14,7.14%),spleen-stomach-renal shunt(SsRS)in 7 cases(7/14,50.00%),both SRS and GRS(SRS&GRS)in 4 cases(4/14,28.57%)and SRS&GRS+SRS dual shunt in 1 case(1/14,7.14%).OC-MIP and VR images did not show the shunt of GRS in 1 case.Among 4 cases of SRS&GRS,DSA showed 1 small branch of splenic vein(SPV)each in 2 cases,while OC-MIP and VR images did not show.The findings of OC-MIP and VR images for source veins were consistent with DSA in the other cases.Conclusion OC-MIP and VR reconstructed CTPA had high clinical value for diagnosing S/sLKS.
2.Oblique coronal position-maximum intensity projection and volume rendering reconstructed CT portal vein angiography for diagnosing spleen/stomach-left kidney shunt
Lin DENG ; Ping LIANG ; Zhongkui HUANG ; Dingjiao ZHU ; Gengrui CHEN
Chinese Journal of Interventional Imaging and Therapy 2025;22(1):32-36
Objective To explore the value of oblique coronal position-maximum intensity projection(OC-MIP)and volume rendering(VR)reconstructed CT portal vein angiography(CTPA)for diagnosing spleen/stomach-left kidney shunt(S/sLKS).Methods A total of 62 patients with decompensated liver cirrhosis who underwent TIPS were retrospectively collected.Based on pre-TIPS enhanced portal vein stage CT,CTPA was reconstructed with OC-MIP and VR technology to diagnose S/sLKS and judging the types.Taken digital subtraction angiography(DSA)findings during TIPS treatment as standards,the efficacy of OC-MIP or VR images for diagnosing S/sLKS were evaluated,and their consistency with DSA for diagnosing S/sLKS were evaluated.Results DSA showed S/sLKS in 14 cases(14/62,22.58%),while no S/sLKS in 48 cases(48/62,77.42%).The sensitivity,specificity and accuracy of OC-MIP and VR images for diagnosing S/sLKS were all consistent,which was 92.86%(13/14),95.83%(46/48)and 95.16%(59/62),respectively.OC-MIP and VR images diagnosed S/sLKS were both consistent with that of DSA(both Kappa=0.865).Among 14 cases of S/sLKS,DSA showed spleen-renal shunt(SRS)and gastro-renal shunt(GRS)each in 1 case(1/14,7.14%),spleen-stomach-renal shunt(SsRS)in 7 cases(7/14,50.00%),both SRS and GRS(SRS&GRS)in 4 cases(4/14,28.57%)and SRS&GRS+SRS dual shunt in 1 case(1/14,7.14%).OC-MIP and VR images did not show the shunt of GRS in 1 case.Among 4 cases of SRS&GRS,DSA showed 1 small branch of splenic vein(SPV)each in 2 cases,while OC-MIP and VR images did not show.The findings of OC-MIP and VR images for source veins were consistent with DSA in the other cases.Conclusion OC-MIP and VR reconstructed CTPA had high clinical value for diagnosing S/sLKS.
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