Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Portography”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Computed tomography during arterial portography in idiopathic portal hypertension.

Computed tomography (CT) during arterial portography was performed in two cases of idiopathic portal hypertension (IPH). Multiple patchy low-density areas with unclear margins and abnormally short distances between some of the medium-sized portal branches and the liver surface were demonstrated. These findings were distinctly different from those of liver cirrhosis. CT during arterial portography was useful for differentiating IPH from liver cirrhosis.

Diagnosis, Differential↗
PubMed1980

Findings in percutaneous transhepatic portography and variceal bleeding in cirrhosis.

Percutaneous transhepatic portography was performed upon 57 patients with cirrhosis and portal hypertension. Forty-nine patients experienced one or more bleeding episodes from gastroesophageal varices. The portographic findings and the free portal pressure were compared with the occurrence and severity of variceal bleeding. The occurrence of bleeding was related to the large cephalad collaterals from the splenic vein and the short gastric veins and coronary vein arising from the splenic vein, and to high portal pressure. The severity of the bleeding was directly related to the same collaterals and to the degree of extrahepatic shunting. No consistent relationships were noted between variceal bleeding and other collateral systems, including gastroesophageal varices. The results possibly indicate that, in patients with cirrhosis, percutaneous transhepatic portography may be of value in planning treatment and assessing the prognosis.

Adult↗
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↗
PubMedDate not supplied

MR imaging during arterial-portography (MR-AP) in the detection of hepatic tumor: comparison with CT-AP.

This study was undertaken to compare the detection rate of hepatic space occupying lesion (SOL)s between computed tomography during arterial portography (CT-AP) and magnetic resonance imaging during arterial portography (MR-AP) and the differences in time intensity curve on MR-AP between HCC, metastatic tumor, FNH, and hemangioma. We performed CT-AP and MR-AP in 17 patients including 14 cases of HCC and one each of metastasis, FNH, and hemangioma. MR-AP was performed by Turbo-FLASH sequence. There was no statistically significant difference between CT-AP and MR-AP in detecting satellite lesions in terms of smallest diameter and number of flow defects (p > 0.05). Hemangioma showed rapid enhancement after the first pass and, consequently, the same enhancement as the hepatic parenchyma. MR-AP was comparable to CT-AP in the detection of hepatic SOLs. Hemangioma showed an enhancement pattern different from those of HCC, metastatic tumor, and FNH, which showed patterns similar to each other.

Carcinoma, Hepatocellular↗
PubMed1995

Computed tomographic portography in preoperative imaging of hepatic neoplasms.

Preoperative selection of suitable patients for liver resection is dependent on the quality of radiological imaging. Computed tomography (CT) identifies approximately 70 per cent of lesions. Computed tomographic arterial portography (CTAP) during contrast enhancement of the liver via the portal vein may be superior to conventional CT. Preoperative CTAP was evaluated in 60 patients with hepatic neoplasm (48 having colorectal metastases) who subsequently underwent laparotomy. The preoperative images were compared with intraoperative palpation, intraoperative ultrasonography and histology of the resected liver. Fifty-six patients (93 per cent) underwent partial hepatectomy. The detection rate sensitivity for CTAP was 110 of 116 lesions in the 56 patients (95 per cent) and for intraoperative ultrasonography was 114 of 116 (98 per cent). CTAP correctly identified all lesions found at histology in 50 of 56 (89 per cent) resected specimens. At laparotomy four of 60 patients (7 per cent) were inoperable; two of these had been predicted to be so by this technique. CTAP correctly identifies and locates the majority of hepatic tumours, particularly metastases, and is the procedure of choice for selection of suitable candidates for partial hepatectomy.

Adult↗
PubMed1990

Recurrence factors studied by percutaneous transhepatic portography before and after endoscopic sclerotherapy for esophageal varices.

High recurrence and rebleeding rates have been reported when endoscopic sclerotherapy has been performed on patients with esophageal varices. We studied the relationship between embolization range and recurrence rate in 26 patients in whom percutaneous transhepatic portography was carried out before and after sclerotherapy. Patients were divided into complete and incomplete embolization groups. The complete embolization group consisted of 16 patients whose esophageal varices had disappeared and in whom embolization of the feeders to the varices had occurred. The incomplete embolization group consisted of 10 patients whose esophageal varices had disappeared, but no embolization had occurred. Recurrence rates within 2 yr after the treatment were compared between complete and incomplete embolization groups. The recurrence rates in the respective groups were 6.7% (1 of 15) and 70.0% (7 of 10), indicating a significant difference between the two groups (p less than 0.05) and indicating that embolization of both esophageal varices and their feeders is essential to lower the recurrence rate after sclerotherapy.

Adult↗
PubMedDate not supplied

Malignant liver lesions: comparison of spiral CT arterial portography and MR imaging for diagnostic accuracy, cost, and effect on patient management.

We compared two imaging techniques, spiral CT arterial portography (CTAP) and MR imaging, for diagnostic accuracy, procedural cost, and effect on management of 26 patients referred for hepatic surgery for suspected limited malignant liver disease. CTAP and MR imaging were done within a 1-week period (19 within 24 hours); the results of the studies were interpreted prospectively by separate reviewers. Surgical data were evaluated in conjunction with imaging data in 10 patients. Lesion detection and segmental involvement were determined and sensitivity and specificity were calculated. Procedural cost was determined from hospital billing codes. Effect on patient management was determined by the referring oncologic surgeon. CTAP and MR imaging showed 185 and 176 true-positive malignant lesions, 15 and zero false-positive malignant lesions, zero and 18 true-negative malignant lesions, and 13 and 22 false-negative malignant lesions, respectively. CTAP and MR imaging showed 107 and 105 true-positive segments, 11 and zero false-positive segments, 80 and 91 true-negative segments, and four and six false-negative segments, respectively. There was a significant difference in specificity of segmental involvement between MR imaging (1.0 +/- 0) compared with CTAP (0.88 +/- 0.05), P = .03. Total procedural cost was $3,499 for CTAP and $1,224 for MR imaging. CTAP findings did not change patient management over MR imaging findings in any patient, whereas MR imaging findings resulted in a change in patient management over CTAP findings in seven patients (P = .015). The results of our study suggest that MR imaging has higher diagnostic accuracy and greater effect on patient management than CTAP does and is 64% less expensive.

Adult↗
PubMed1996

CT during arterial portography.

CT during arterial portography (CTAP) is based on portal enhancement of the liver by infusion of contrast material through the superior mesenteric or splenic artery. This technique provides high degrees of enhancement of the portal vein and intrahepatic vessels, allowing reliable segmental localisation of tumours and accurate assessment of relationships between tumours and intrahepatic vessels. Because of its invasiveness, CTAP must be limited to patients for whom non-invasive preoperative imaging suggests resectable tumour. In the majority of cases, CTAP is performed in patients with hepatic metastases from colorectal cancer, but other types of hepatic tumour (either primary or secondary) and pancreatic tumour may be an indication for CTAP. Visualisation of non-tumorous perfusion defects is a limitation of this technique, but such defects have been well described and have characteristic locations and appearance. In difficult cases, correlation with sonographic, CT and MRI findings helps characterise portal perfusion defects. CTAP is the most sensitive technique for the detection of intrahepatic tumours, and the recent use of spiral technology shows promise in the performance of CTAP. CTAP data can be viewed as multiplanar and three-dimensional reconstructions that allow preoperative planning of the extent of resection and determination of the volume of the remaining liver after resection.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

The association of paracardial adenopathy with hepatic metastasis found on CT arterial portography.

BACKGROUND: The association of paracardial lymphadenopathy with hepatic metastases in patients undergoing computed tomographic arterial portography (CTAP) prior to possible resection of hepatic metastases is documented. METHODS: CTAP was performed on 45 patients with hepatic metastasis, including 30 with colorectal carcinoma, using 1 cm increments from the dome of the diaphragm through the liver. Two radiologists, blinded to the diagnosis and surgical results, reviewed all portograms and identified all paracardial lymph nodes larger than 8 cm. RESULTS: Enlarged paracardial lymph nodes were found in three of the 30 colorectal carcinoma patients and two of the remaining 15 patients. All three colorectal patients with paracardial lymphadenopathy demonstrated massive metastatic involvement of the anterior segment of the right hepatic lobe (segment 8: Couinaud nomenclature). Additional metastasis in the superior aspect of the liver was seen in two of these patients as well. Both patients without colorectal carcinoma with paracardial lymphadenopathy had metastasis involving the superior aspect of the liver. Paracardial lymphadenopathy was right-sided in all five patients and bilateral in one. By contrast, 48% (19 of 40) of patients without enlarged paracardial lymph nodes had metastasis in the anterior segment of the right lobe. CONCLUSIONS: This study suggests that paracardial lymphadenopathy is associated with metastatic disease to specific areas within the liver. This nodal involvement can be attributed to lymphatic drainage from the diaphragmatic surface of the liver.

Adult↗
PubMedDate not supplied

Involvement of superior mesenteric vessels and portal vein in pancreatic adenocarcinoma: detection with CT during arterial portography.

A prospective study was designed to determine the utility of computed tomography (CT) during arterial portography (CTAP) in the detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma. Eighteen patients with adenocarcinoma of the head of the pancreas and eight patients with benign pancreatic disease were investigated with CTAP, dynamic contrast-enhanced CT, and angiography. Appropriate review was made to determine presence or absence of superior mesenteric vessels and portal vein involvement. Final diagnosis was obtained in all cases by surgical explorations. The overall accuracy rate for detecting or excluding superior mesenteric vessels and portal vein involvement was 96% (25 of 26 patients) with CTAP, 88% (23 of 26 patients) with dynamic contrast-enhanced CT, and 85% (22 of 26 patients) with angiography. No statistically significant difference in accuracy was found among the three techniques. Our results suggest that the use of CTAP is not indicated in the preoperative detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma.

Adult↗
PubMedDate not supplied

Hepatocellular carcinoma: findings on spiral CT during arterial portography.

BACKGROUND: To determine characteristic imaging features of hepatocellular carcinoma (HCC) on spiral CT during arterial portography (SCTAP) and to correlate the presence or absence of spontaneous portosystemic shunts with the degree of hepatic parenchymal enhancement during SCTAP in patients with HCC. METHODS: SCTAP scans of 20 patients with HCC were retrospectively analyzed for tumor features, degree of hepatic parenchymal enhancement, and presence or absence of spontaneous portosystemic shunts. RESULTS: Nineteen tumors (95%) were hypoattenuating masses and one (5%) was isoattenuating compared with the liver on SCTAP. In seven patients (35%), the tumor was homogeneous in attenuation. Tumor margins were smooth and regular in 12 patients (60%). Vascular invasion and encapsulation were depicted in 10 patients (50%). A high degree of hepatic parenchymal enhancement was observed in 14 patients; one of them (7%) had spontaneous portosystemic shunts. Poor or moderate enhancement was observed in six patients; five of them (83%) had spontaneous portosystemic shunts (p < .001). CONCLUSION: The presence of a low attenuated homogeneous intrahepatic mass with associated vascular invasion on SCTAP scans should raise the possibility of HCC. The presence of spontaneous portosystemic shunts is associated with poor or moderate parenchymal enhancement.

Adult↗
PubMed1991

Detection by CT during arterial portography of colorectal cancer metastases to liver.

A prospective evaluation of the accuracy of real-time ultrasonography (US), computed tomography (CT), infusion hepatic angiography (IHA), and computed tomography during arterial portography (CT-AP) was performed on 65 resected liver metastases of colorectal cancers. The total detection rate was 58.5 percent for US, 56.3 percent for CT, 55.4 percent for IHA, and 86.2 percent for CT-AP. The sensitivity of 29 lesions with diameters of smaller than 1 cm was 65.5 percent for CT-AP, CT found only two, and both US and IHA localized no more than three. The smallest lesions detectable by CT-AP were as small as 0.4 cm in diameter. CT-AP proved most useful in detecting the liver metastases, and the use of this technique is recommended for preoperative planning of hepatectomy on patients with liver metastases.

Angiography↗
PubMedDate not supplied

Balloon occlusion portography to diagnose new-onset left hepatic vein thrombosis and widening of an existing Wallstent TIPS by Palmaz stents for recurrent portal hypertension and variceal bleeding.

A 31-year-old man with Child's class A micronodular cirrhosis, left lobe hypertrophy, and a transjugular intrahepatic portosystemic shunt (TIPS) which had been placed 6 months earlier, was admitted for recurrent esophageal bleeding and a portosystemic gradient of 42 mmHg. Balloon occlusion portography documented unsuspected ostial thrombosis of the previously patent left hepatic vein. This was considered the cause of the pressure rise. As it was not possible to insert a second TIPS in parallel, the shunt, stented originally with 10-mm Wallstents, was overdilated to 12 mm, and two 12-mm Palmaz stents were placed coaxially, reducing the portosystemic pressure gradient to 13 mmHg.

Adult↗
PubMed1987

Balloon-occluded arterial portography using prostaglandin E1: improved visualization of the intrahepatic portal vein.

For improved visualization of the intrahepatic portal vein, balloon-occluded superior mesenteric arteriography was performed using a torque-controlled balloon catheter after injection of 20 micrograms prostaglandin E1. In patients who underwent arterial portography twice, i.e., by the method using prostaglandin E1 alone and the prostaglandin E1 plus the balloon method, the latter method provided better visualization, particularly in cases in which an aberrant right hepatic artery arose from the superior mesenteric artery.

Alprostadil↗
PubMed1998

Detection of colorectal liver metastases: prospective comparison of unenhanced and ferumoxides-enhanced magnetic resonance imaging at 1.5 T, dual-phase spiral CT, and spiral CT during arterial portography.

The purpose of this study was to compare the efficacy of unenhanced and ferumoxides-enhanced magnetic resonance imaging with that of dual-phase spiral CT and spiral CT during arterial portography (CTAP) for the detection of colorectal liver metastases. Fourteen patients with liver metastases candidates for partial hepatectomy were examined with dual-phase spiral CT, unenhanced and ferumoxides-enhanced MR imaging at 1.5 T, and spiral CTAP. Imaging tests were read blinded, prospectively, quantitating number of lesions excepting CTAP which used US to exclude cysts. Subsequent intraoperative US and pathologic findings were correlated with preoperative imaging results. At surgery, 36 lesions 0.5-13 cm in diameter (mean+/-standard deviation, 2.9+/-2.1 cm) were identified. Dual-phase spiral CT depicted 21/36 (58%); precontrast MR imaging, 19/36 (53%); ferumoxides-enhanced MR imaging, 30/36 (83%); and spiral CTAP, 34/36 (94%) lesions. Ferumoxides-enhanced MR imaging was significantly more sensitive than spiral CT and unenhanced MR imaging (P < 0.01). The difference in sensitivity between ferumoxides-enhanced MR imaging and spiral CTAP was not statistically significant (P> 0.1). Spiral CTAP, however, depicted nine false-positive lesions (2 hemangiomas, 7 perfusion defects). The positive predictive value was 79% for spiral CTAP and 100% for combined pre- and postcontrast MR imaging. We conclude that ferumoxides-enhanced MR imaging is superior to unenhanced MR imaging and biphasic spiral CT for depiction of colorectal liver metastases. Further investigation is needed to clarify whether MR imaging with use of ferumoxides might replace spiral CTAP for preoperative evaluation of liver resection candidates.

Adult↗
PubMed1999

Preliminary clinical application of contrast-enhanced MR portography.

The clinical application of contrast enhanced (CE) MR was evaluated. A total of 66 CE MR portograms were obtained by performing fast imaging with steady procession (FISP) technique on a 1.5-T Siemens magnetom vision. A maximum intensity projection algorithm was also employed to include all vessels in a single image. The patency of portal venous system, the presence and extent of varices were also evaluated. The results showed that all images had diagnostic quality. Main portal vein (MPV) and its 4th-6th level intrahepatic branches were visualized in 10 normal persons serving as control. The diameter of MPV, splenic vein and superior mesenteric vein was 1.02 +/- 0.21, 0.8 +/- 0.15, 0.8 +/- 0.26 cm respectively, which were significantly lower than that in portal hypertension patients (1.38 +/- 0.27, 1.26 +/- 0.18, 1.24 +/- 0.18 cm, respectively). In 23 preoperative cases of portal hypertension, dilated portal vein and tortuous enlarged splenic vein were found in 23 cases; esophageal and coronary varices in 12 and 19 cases, respectively. In 7 postoperative re-examined cases with portal hypertension, the flow velocity and flow of MPV were decreased in all cases and esophageal varices could still be observed in 3 cases. New vessels appeared in the great curvature of stomach in 2 cases. In 20 cases of liver carcinoma, occlusion of MPV or its intrahepatic branches were showed in 14, compression and dislocation of intrahepatic portal vein were found in 6. In other 6 cases, 2 were splenic venous thrombosis and 4 were tumors in the intestine or retro-peritoneum. It is concluded that three-dimensional CE MR portography is an accurate technique for evaluating the portal venous system. It is a reliable and noninvasive technique that can provide important information for the evaluation of patients' condition before TIPSS and liver transplantation.

Contrast Media↗
PubMed1993

Accuracy of computed tomography during arterial portography in the segmental localization of liver tumours.

The ability of computed tomography during arterial portography (CTAP) to identify and segmentally locate 20 hepatic tumours was prospectively assessed in 7 patients undergoing hepatic resection. All eight lesions greater than 2.5 cm in diameter were detected, but only two out of four and two out of eight of those measuring 1-2.4 cm and < 1 cm respectively. The overall segmental localization accuracy for detected lesions was 91%. Our results highlight the insensitivity of CTAP to hepatic lesions smaller than 1 cm in size, but have shown the accuracy of segmental localization for detected lesions.

Carcinoma, Hepatocellular↗