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Results for “Portography”

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At least 19 recordsLinked to original sources

PubMed1992

Preoperative assessment of resectability of hepatic metastases from colonic carcinoma: CT portography vs sonography and dynamic CT.

OBJECTIVE: A retrospective study was performed to determine the influence of CT portography vs sonography and dynamic CT on the preoperative assessment of the resectability of hepatic metastases from colorectal cancer. MATERIALS AND METHODS: Results of sonography, bolus dynamic CT, and CT portography in 28 patients who underwent surgical exploration (resection or intraarterial catheter placement) for hepatic metastases from colorectal cancer were retrospectively reviewed by two abdominal radiologists and one hepatic surgeon. For each patient, the resectability and surgical approach were decided on the basis of the results of combined sonography-bolus dynamic CT and compared with the decision made from the CT portographic results alone. The final approach suggested was compared retrospectively with the surgical procedure actually performed. RESULTS: Sixty-nine metastases were identified at surgery and pathologically proved. Combined sonography-bolus dynamic CT and CT portography showed 52 (75%) and 64 (93%) metastases, respectively. Twelve metastases in five patients were seen only with CT portography. In four patients, CT portography depicted additional metastases, which changed the surgical approach that had been chosen on the basis of results of sonography and bolus dynamic CT. In one patient, CT portography showed four additional metastases, precluding hepatic resection. CONCLUSION: Findings from CT portography provide vital data unattainable with sonography and bolus dynamic CT that improve the preoperative assessment of the resectability of liver metastases from colonic carcinoma.

Colorectal Neoplasms↗

PubMed1989

[CT portography in malignant space-occupying lesions of the liver].

CT portography was performed in 32 patients with liver tumours and in four patients with cirrhosis of the liver, but without evidence of tumour, after angiographic injection of contrast into the superior mesenteric or splenic arteries. Compared with CT using no contrast, or contrast by intravenous injection, CT portography has the following advantages: better tumour detection, better detection of tumour size, better demarcation and localisation of tumours, better demonstration of the portal system, more inhomogeneity of the parenchyma. Of 12 patients with a number of tumours shown on CT, CT portography demonstrated tumours in four cases, which could not be shown by any other imaging method. Problems concerning CT portography in patients with cirrhosis of the liver are discussed.

Adult↗

PubMed1988

Assessment of portal vein patency: comparison of arterial portography and ultrasound scanning.

The accuracy of ultrasound assessment of portal vein patency has been defined by comparing it with the results of arterial portography in 115 cases. The accuracy of arterial portography was confirmed in 21 cases where orthotopic liver transplantation was performed and used as a 'bench-mark' against which to assess the ultrasound findings. Ultrasound correctly assessed portal vein patency in 87.5% of patients. It was more accurate in assessing patency (90%) than occlusion (68%). Ultrasound correctly assessed portal vein patency in 90% of cases of cirrhosis and hepatic malignancy. Difficulties occurred in children with biliary atresia particularly following the Kasai operation (37.5% accuracy). In the absence of previous surgery to the portal vein or biliary system, ultrasound is comparable to arterial portography and can be used as the sole means of assessment.

Adolescent↗

PubMed1976

[Trans-jugular retrograde portography. Preliminary communication].

Retrograde portography is carried out through a trans-jugular route. Contrary to previously available techniques of trans-juglar portography, the method does not inflict any trauma on the parenchyma or vessels. Demonstration of the portal system is achied by reserved flow through the liver sinusoids. Together with arterial hepatography and indirect splenic and mesenteric portography, the method provides additional information in various forms of pre-, intra- and post-hepatic block without submitting the patient to any additional risk.

Aged↗

PubMed1992

Preoperative radiological evaluation of the liver by computerized tomographic portography in patients with hepatic tumors.

The main objective of preoperative imaging studies is to define as accurately as possible the number, size, location, and relationship of tumor masses in the liver to pertinent portal and hepatic venous vasculature. Computerized tomographic portography images hepatic veins and segmental portal vein branches and identifies the anatomical location of tumor nodules with excellent sensitivity and a low false-positive rate. The intraoperative correlation of computerized tomographic portography on 30 patients in the last 20 months at this institution shows a sensitivity of 88 per cent with a low rate of false-positivity. The ability to detect metastatic lesions in the liver by computerized tomographic portography diminishes when the lesions are noted to be less than 1 cm. The authors conclude that the preoperative interpretation of the computerized tomographic portogram provides valuable information not previously available to the surgeon operating on the liver.

Adult↗

PubMed1989

[An experimental comparative study of several vasodilators for enhancing arterial portography].

In order to improve visualization of the portal vein, an experimental comparative study of enhancing arterial portography with four vasodilators was conducted in 8 dogs and the hemodynamic changes observed after administration of these agents. This study confirms that prostaglandin E1. Vasoactive intestinal peptide and anisodamine can improve the image quality of portal vein in arterial portography, but priscoline is less effective. The mechanism, and technical factors involved and the clinical application of pharmaceutical-arterial portography were discussed. This study also provided the experimental data for a wide choice of vasodilators in enhancing visceral angiography.

Animals↗

PubMed1991

Staging of hepatocellular carcinoma by ultrasonography, computed tomography, and angiography: the role of CT combined with arterial portography.

A series of 60 patients with hepatocellular carcinoma (HCC) were evaluated over a 2-year period of ultrasonography (US), computed tomography (CT), and angiography. The angiographic studies carried out with intraarterial digital technology were compared to both US and CT of the liver. In 16 of 60 patients, we observed discordance of the findings obtained with angiography, CT, and US. We therefore compared these three methodologies in those cases where diagnostic discordance was noted. In our experience, US had a sensitivity of 73.4%, 76.7% for CT, and 95% for angiography. In 13 of 60 patients, we performed CT with arterial portography (CTAP) which demonstrated a better resolution than conventional CT. In view of the sensitivity of US - comparable to that of CT - and for the even greater sensitivity of intraarterial digital angiography, we performed an US study of patients at risk of HCC. CT was found to play a diagnostic/staging role after angiographic study has been performed, especially when enhanced by arterial portography.

Adult↗

PubMedDate not supplied

Computed tomography during arterial portography prior to transcatheter arterial therapy in hepatocellular carcinoma with marked portal extension: four case reports.

Computed tomography during arterial portography (CTAP) is acknowledge as a valuable preoperative method for the detection of small intrahepatic lesions in patients with liver neoplasm. Four patients with hepatocellular carcinoma (HCC) with marked portal extension are presented. Evaluation of intrahepatic portal blood flow was achieved more accurately by CTAP than by conventional arterial portography. CTAP also plays an important role in patients with inoperable HCC, since portal extension is the most important prognostic factor of transcatheter arterial therapy.

Adult↗

PubMed1977

[Transjugular puncture of the portal vein. Portography and selective phlebography of abdominal organs. An experimental study in dogs (author's transl)].

Transjugular transhepatic portography is a new method for catheterising the portal vein and its tributaries. In order to gather experience of the method before applying it clinically, the transvenous approach was studied in six dogs. Transjugular portography has the following advantages as compared with umbilical vein catheterization and percutaneous, transhepatic portal vein catherterisation: 1. Because of the relative positions of the jugular veins, vena cava and portal vein, manipulation of the catheter for selective phlebography is simpler. 2. There is no risk of a haemoperitoneum or bile peritonitis if a correct technique is used since the liver capsule remains intact. 3. In the presence of portal hypertension, it may be possible in future to create an intrahepatic portocaval shunt by the transjugular approach without a major operation. Sclerosis of oesophageal varices is possible, as it is with the other procedures.

Animals↗

PubMed1992

CT arterial portography: causes of technical failure and variable liver enhancement.

OBJECTIVE: We studied the causes of technical failure and enhancement variability encountered during CT arterial portography. MATERIALS AND METHODS: CT arterial portograms and digital arteriograms were obtained via the superior mesenteric artery before partial liver resection in 43 patients with malignant tumors. These studies were reviewed for causes of technical failure and variable enhancement. RESULTS: Eleven (26%) of 43 procedures were technical failures. Causes of failure included aortic injection after catheter dislodgement (four), dense hyperenhancement associated with laminar flow in the portal vein produced by rapid venous return from a selective injection into a proximal branch vessel of the superior mesenteric artery (two), premature scanning beginning at the iliac crest (two), reflux into a replaced right hepatic artery (one), hepatic arterial enhancement via the pancreaticoduodenal arcade (one), and portal hypertension (one). Of the 32 remaining studies, 28 showed areas of parenchymal hypoenhancement or hyperenhancement. Causes of variable enhancement included impaired portal vein perfusion from mass effect of the tumor, laminar flow in the portal vein, and focal fatty infiltration. CONCLUSION: Technical failures and enhancement variability are common in CT arterial portography. Factors leading to technical failure include catheter choice and position, portal hypertension, and operator error.

Carcinoma, Hepatocellular↗

PubMed1989

[Percutaneous transhepatic portography in patients with hepatocellular carcinoma: percutaneous transhepatic portal venous embolization].

Percutaneous transhepatic portography was performed in 28 patients with HCC and PTPE was attempted in 9 of them. Displacement of the portal vein was found in 37% of 52 HCCs. Other portographic findings were: encasement (19%), avascular area (19%), occlusion (10%), narrowing (4%), neovascularization (4%), tumor staining (2%). Frequency of the tumor-related portography findings was found to be increased in relation to tumor size. TAE followed by PTPE with stainless steel coil (6 cases) or microcapsule form of MMC (3 cases) was performed on 9 cases. PTPE appears to be a promising adjuvant to conventional TAE.

Aged↗

PubMed1989

[Evaluation of the relationship between esophageal varices and azygos vein using percutaneous transhepatic cine-portography].

To evaluate the relationship between esophageal varices and the azygos vein--which is generally considered to drain the major part of the esophageal variceal blood--we examined 36 patients with portal hypertension using percutaneous transhepatic cine-portography. The patients were classified into three groups (azygos, cervical and combined) according to the amount of blood to be considered drained by the azygos vein. Eighteen patients (50%) fell into the azygos type group, five (14%) into the cervical, and 13 (36%) into the combined. Highly developed esophageal varices were recognized endoscopically in all patients in the combined and cervical type groups while some of the patients in the azygos type group had less well developed varices. In the azygos type group, there was a tendency for the varices to be increasingly severe the higher the part of the azygos vein they drained into. Because it helps us to fully comprehend the significance of the azygos venous blood flow and the occasionally uncertain effect of endoscopic injection sclerotherapy for esophageal varices, it is important to evaluate the drainage route of esophageal varices in vivo and in detail. Percutaneous transhepatic cine-portography is the useful method for this purpose as it enables us to visualize even the most minute blood stream.

Aged↗

PubMed1978

[Results of percutaneous transhepatic portography (author's transl)].

The technique, indications, contraindications and complications of percutaneous transhepatic portography based on the experience of 300 cases are described. The advantage of this method is discussed and compared with transjugular and transumbilical portography.

Esophageal and Gastric Varices↗

PubMedDate not supplied

Dynamic computed tomography during arterial portography: the most sensitive examination for small hepatocellular carcinomas.

The efficacy of dynamic sequential CT with table incrementation during arterial portography (DSCTI-AP) in the detection of small hepatocellular carcinomas (HCC) (less than 3 cm in diameter and less than three in number) was analyzed in comparison with other imaging methods including radionuclide (RN) liver scans, ultrasound (US), CT, selective celiac angiography (SCA), and infusion hepatic angiography (IHA). The sensitivity of each study in detecting 19 cases of small HCC was as follows: RN, 16%; US, 63%; CT, 58%; SCA, 58%; IHA, 83%; and DSCTI-AP, 95%. Three of 19 cases were diagnosed only by DSCTI-AP and one case that could not be visualized by DSCTI-AP was opacified by IHA. Dynamic sequential CT with table incrementation during arterial portography was superior to IHA in visualizing small HCCs.

Adult↗

PubMed1978

Percutaneous transhepatic portography.

The technique, indications, contraindications and complications of percutaneous transhepatic portography and selective catheterization of the major and minor veins draining the splanchnic organs based on the experience of 200 cases are described. The advantage of this method is discussed and compared with transjugular and transumbilical portography.

Adult↗

PubMed1979

Percutaneous transhepatic portography. II. Comparison with splenoportography in portal hypertension.

Percutaneous transhepatic portography and splenoportography were compared in 67 patients with portal hypertension. Portograms were evaluated without knowledge of the identity of patients. Factors evaluated included technical success of the examination; visualization of the portal vein, splenic vein, and other tributaries; contrast medium density, portal blood flow direction; presence and type of collaterals and varices; and liver size and configuration. Percutaneous transhepatic portography proved superior with regard to delineation of the portal venous system and esophageal varices. A definite diagnosis of portal vein thrombosis was possible only with the transhepatic approach.

Adolescent↗

PubMed1978

Correlation between percutaneous transhepatic portography and clinical findings in 56 patients with portal hypertension.

56 consecutive patients with portal hypertension were studied with percutaneous transhepatic portography and the results were correlated to clinical findings and the number of upper gastrointestinal haemorrhages and the size of the individual bleeding. An abundance of collateral paths was noted in most patients. No regularity in development of these collaterals was found. It was not correlated to liver disease etiology, sex or liver function parameters. Portal pressure was not correlated to the size or amount of collaterals. In four patients with liver cirrhosis hepato-fugal flow in one segment of the liver was noted proving that portal flow through the liver is not uniform in this disease. The size of the haemorrhages was only correlated to presence of hepato-fugal flow in the main stem of the portal vein. It was not correlated to the estimated size of the oesophageal varices or to portal pressure. Percutaneous transhepatic portography seems to be of little help in selecting "high risk bleeders" in portal hypertension. Other factors may be of greater help in this task as indicated by the findings in this investigation that patients with alcohol cirrhosis had larger haemorrhages than those with cirrhosis of another etiology and that patients with none or few bleeding episodes had higher thrombocyte count than those with several haemorrhages.

Aged↗

PubMed1977

[Results of transjugular antegrade cholangiography and retrograde portography (author's transl)].

Via the jugular approach to the liver diagnosis of the liver could be extended by transjugular cholangiography, liver biopsy and retrograde portography. Transjugular cholangiography makes possible an antegrade picture of the bile ducts - particularly when conventional techniques or retrograde measures fail. 85% of blocked bile ducts were recognized. Transjugular liver biopsy complements cholangiography. Tissue can be removed from right and left lobes of the liver. Retrograde portography makes possible assessment of hemodynamics of the liver in portal hypertension before and after shunt operations. Isolated pictures of portal circulation in the right or left lobes permits clear allocation of tumorous or parasitical disease in the respective parts of the liver. This is of special importance for surgery of the liver, a precondition of hemihepatectomy.

Adult↗