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 145 records · Page 8Linked to original sources
PubMedDate not supplied

Role of computed tomographic arterial portography and intraoperative ultrasound in the evaluation of patients for resectability of hepatic lesions.

Computed tomographic arterial portography (CTAP) has been shown to be the most sensitive preoperative test for determining resectability of hepatic lesions but we have shown it to have low specificity. Intraoperative ultrasound (IOUS) evaluation of the liver has also been proposed as an accurate means of assessing resectability. We sought to compare the effectiveness of the two modalities. Fifty-six patients who had been deemed candidates for liver resection based on CTAP findings underwent systematic exploration, liver mobilization, and IOUS examination. Ultrasound findings were compared with results of CTAP. In 46 patients the IOUS findings were in complete agreement with those of CTAP. In 10 patients CTAP lesions could not be verified by IOUS and these patients did not undergo resection. Follow-up of these 10 patients revealed eight who did not have progression of malignancy at the CTAP-predicted site (CTAP false positive). Two patients did have progression at a CTAP-positive IOUS-negative site (IOUS false negative). Sensitivity for CTAP and IOUS was 100% and 96%, respectively. Specificity for IOUS was 100%. These findings demonstrate the high sensitivity of CTAP and the high sensitivity and specificity of IOUS. CTAP may "overcall" hepatic lesions but IOUS can correctly identify these false positives in most instances. Because CTAP is useful for determining which patients might benefit from surgical exploration, we conclude that the two modalities are complementary for the assessment of resectability of hepatic lesions. The false positive rate for CTAP implies that caution must be used when declining to operate on patients on the basis of this test.

Adult↗
PubMed1999

Value of percutaneous transhepatic portography before hepatectomy for hilar cholangiocarcinoma.

BACKGROUND: The diagnostic value of percutaneous transhepatic portography (PTP) for assessing cancer invasion of the portal bifurcation in patients with hilar cholangiocarcinoma has not been studied previously. METHODS: From April 1977 to March 1998 combined hepatobiliary and portal vein resection was performed in 45 patients. In 25 patients, PTP was carried out before operation and the resected portal bifurcation was examined histologically. Correlation between portographic and microscopic findings at the portal bifurcation was studied retrospectively. RESULTS: Portographic and microscopic findings were classified into three groups (type A, B or C, and grade 0, I or II respectively) according to the findings at the portal bifurcation. There was a significant correlation between the portographic type and degree of cancer invasion (P = 0.0001). In seven of the eight patients with type A portograms, there was no microscopic cancer invasion of the portal bifurcation. In 15 of the 17 patients with type B or C portograms, cancer invasion was found microscopically. All patients with microscopic grade II invasion had type C portograms. CONCLUSION: PTP can be used to evaluate cancer invasion of the portal bifurcation with sufficient reliability for preoperative staging of hilar cholangiocarcinoma.

Adult↗
PubMed1999

Haemodynamic changes in non-alcoholic (viral) liver cirrhosis studied by computed tomography (CT) arterial portography and CT arteriography.

AIMS: To evaluate haemodynamic and vascular changes in non-alcoholic (viral) cirrhosis on conventional computed tomography (CT), CT arteriography (CTA) and CT arterial portography (CTAP), and to determine the cause of the observed reticular stain on angiography. METHODS: Using surgically resected liver specimens from 31 patients with viral hepatitis associated hepatocellular carcinoma, images of conventional CT, CTA, CTAP and the sinusoidal phase of hepatic arteriography were retrospectively analysed and compared with pathology of the non-cancerous portion of the liver. RESULTS: Computed tomography arteriography showed inhomogeneous enhancement (diffuse, low-density nodules) in a total of 16 samples (52%); in eight of 10 (80%) cirrhotic livers, three of six (50%) precirrhotic livers, five of 12 (42%) livers with chronic active hepatitis and none of three with no active liver disease. The frequency of inhomogeneous enhancement became significantly higher with increasing severity of parenchymal damage (P < 0.05). In contrast, conventional CT and CTAP showed homogeneous enhancement in all 31 (100%) patients. There was no correlation between inhomogeneous enhancement on CTA and reticular staining on sinusoidal-phase hepatic angiograms. Inhomogeneous enhancement was frequently seen in patients with hepatitis B surface antigen and/or anti-hepatitis C virus antibody compared with those without them (P < 0.05). CONCLUSION: The CTA was much more sensitive in detecting haemodynamic changes in the cirrhotic liver than CTAP, conventional CT and sinusoidal-phased hepatic angiography. Further study is required to clarify the mechanism of inhomogeneous enhancement on CTA and homogeneous enhancement on CTAP seen in cirrhosis.

Adult↗
PubMed2002

Hepatic nodules with early enhancement during computed tomography portography: report of six cases.

AIM: To study the clinicopathologic characteristics of hepatic nodular lesions with high attenuation (increased portal blood flow) compared with surrounding hepatic parenchyma on computed tomography (CT) during arterial portography (CTAP). METHODS: For six lesions found in six patients demonstrated as a high-attenuated mass by CTAP, CT during hepatic arteriography (CTHA; n = 3 patients), digital subtraction hepatic arteriography (n = 6) and conventional helical CT (n = 6) were evaluated retrospectively and compared with histopathologic findings (n = 4). Pathologic diagnosis was atypical adenomatous hyperplasia, nodule-in-nodule hepatocellular carcinoma (HCC) in one resected lesion each and overt HCC in two biopsied lesions. Two patients did not undergo any therapy and were followed up. RESULTS: The average size of lesions was 2.2 cm (range 1.2-3.5 cm). The CTAP revealed high attenuation in all six lesions; entirely within the lesion (n = 4 lesions) or peripherally with a central low attenuation (n = 2). In contrast, CTHA showed low attenuated lesions; entirely within the mass (n = 2) or peripherally with a central high-attenuated spot (n = 1). Hepatic arteriogram revealed only two hypervascular lesions; entirely and partially in one each. In the arterial phase of helical CT, all but one lesion were iso- or hypo-attenuated. In two patients who were followed up to 39 and 55 months without therapy, neither tumor growth nor hemodynamic change of the lesion was recognized on CT. CONCLUSIONS: Even though the incidence of hepatic nodular lesions demonstrated as high attenuating on CTAP is low, all but one lesion in the current series showed iso- or hypo-attenuation on CTHA and/or helical CT, suggesting the hemodynamics are reciprocal between CTAP and CTHA. One exceptional lesion that showed high attenuation on both CTAP and conventional CT was pathologically advanced HCC. Based on the follow-up study of two untreated patients, this kind of lesion with high attenuation on CTAP seems to grow slowly.

Aged↗
PubMed2000

Hepatic arterioportal shunts not directly related to hepatocellular carcinoma: findings on CT during hepatic arteriography, CT arterial portography and dual phase spiral CT.

AIM: To evaluate findings of arterioportal shunts not directly related to hepatocellular carcinoma (HCC) which were seen within third-order portal branches on computed tomography (CT) during hepatic arteriography (CTHA), arterial portography (CTAP), and dual phase spiral CT. MATERIALS AND METHODS: At CTHA in 112 patients, we examined third-order portal vein branches to find arterioportal shunts not directly related to HCC. Six cases were found. We evaluated the findings of these shunts on CTHA and investigated whether CTAP (n = 6) and dual phase spiral CT (n = 5) showed perfusion defects in the corresponding areas on arterioportal shunts. RESULTS: Five of six cases showed abrupt visualization of portal branches without visualization of the proximal portion of CTHA. Five of six cases showed no perfusion defect on CTAP and no hyperattenuating area on CTHA. Four of five cases showed no hyperattenuating area on hepatic arterial phase spiral CT. CONCLUSION: Arterioportal shunts not directly related to HCC and occuring within third-order portal branches mainly showed abrupt visualization of portal branches on CTHA. These occurred frequently without perfusion defects on CTAP and without a hyperattenuating area on CTHA and hepatic arterial phase spiral CT.Park, C. M. (2000). Clinical Radiology55, 465-470.

Adult↗
PubMed2001

Pre-operative detection of malignant hepatic tumours: value of combined helical CT during arterial portography and biphasic CT during hepatic arteriography.

AIMS: The purpose of our study was to evaluate the observer performance with combined helical CT during arterial portography (CTAP) and biphasic CT hepatic arteriography (CTHA) in the pre-operative detection of malignant hepatic tumours. METHODS: Computed tomography images obtained in 41 patients with suspected hepatic tumours were retrospectively reviewed. In a blind fashion, three off-site, independent radiologists reviewed CTAP and early-phase CTHA combined for the first review, then late-phase CTHA was added for the second review. Statistical analysis was conducted on lesion-by-lesion and segment-by-segment bases; a total of 328 liver segments including 65 segments with 74 malignant hepatic tumours ranging in size from 5 to 100 mm (mean, 21.4 mm) were analysed. RESULTS: Sensitivity for detection of liver segments harbouring tumours of CTAP and biphasic CTHA combined (82%) was identical to that of CTAP and early-phase CTHA combined (82%). Specificity of CTAP and biphasic CTHA combined (93%) was greater than that of CTAP and early-phase CTHA combined (90%, P < 0.005). The mean confidence level for the 74 tumours significantly increased by adding late-phase CTHA (P < 0.0005). The mean confidence level for 100-142 benign perfusion abnormalities detected with CTAP and early-phase CTHA combined significantly decreased by adding late-phase CTHA (P < 0.0005). CONCLUSION: By combining late-phase CTHA with CTAP and early-phase CTHA information, the specificity for the detection of malignant hepatic tumours rises significantly, allowing more accurate preoperative tumour detection.

Aged↗
PubMed2000

Probability of hepatocellular carcinoma of small hepatocellular nodules undetectable by computed tomography during arterial portography.

Recent advances in imaging modalities enable the identification of small hepatocellular nodules. Among the imaging techniques currently used for detecting hepatocellular carcinomas (HCC), computed tomography (CT) during arterial portography (CTAP) is one of the most sensitive techniques available for detecting hemodynamic change. Even so, well-differentiated HCCs that display only limited hemodynamic change, a feature shared with nonmalignant hepatocellular nodules, are not always detectable by CTAP. To improve our ability to distinguish well-differentiated HCCs from nonmalignant hepatocellular nodules, we have attempted to clarify how the characteristics of the nodules are shown by each imaging technique. We studied the imaging and pathological characteristics of 31 nodules (in 22 patients) detected by ultrasonography (US), but not by CTAP. Histological diagnoses were as follows: HCC, 17 of 31 nodules (55%); high-grade dysplastic nodules, 1 of 31 (3%); and nonmalignant nodules, 13 of 31 (42%). Neither digital substraction angiography (DSA) nor CT arteriography (CTA) were able to detect any of the nodules. Detection rates for plain CT were: 5 of 17 (29%) HCC, 1 of 1 (100%) high-grade dysplastic nodules, and 1 of 13 (8%) nonmalignant nodules. Detection rates for T1/T2-weighted magnetic resonance imaging (MRI) were: 4 of 17 (24%) HCC, 1 of 1 (100%) high-grade dysplastic nodules, and 3 of 13 (23%) nonmalignant nodules. Dynamic CT and dynamic MRI provided no additional information. In conclusion, there is some probability that hepatocellular nodules detected by US, but not by CTAP, are HCC. Presently, it is difficult to distinguish between benign nodules and malignant ones with these imaging techniques, and our findings indicate that biopsy may be advisable for nodules detected under these conditions.

Adult↗
PubMed2002

Diagnosis of hepatic neoplasms using CT arterial portography and CT hepatic arteriography.

Both computed tomography arterial portography (CTAP) and CT hepatic arteriography (CTHA) are CT techniques with angiographic assistance. The detection sensitivity of these techniques is high because marked lesion contrast can be obtained using direct delivery of contrast materials to the liver parenchyma or the tumors. The use of CTAP and CTHA may improve therapeutic results after transarterial embolization therapy for hepatocellular carcinomas because of their high diagnostic accuracy. Findings on CTAP or CTHA can sometimes help characterize the hepatic focal lesions. Thus, CTAP and CTHA are frequently performed as pretreatment examinations, although they are invasive compared to intravenous (IV) contrast-enhanced CT or magnetic resonance imaging. However, there are some potential pitfalls, such as nontumorous perfusion abnormalities. CTAP and CTHA are less effective for evaluation of patients with cirrhosis and portal hypertension. This article presents a current overview of CTAP and CTHA technique for diagnosis of hepatic neoplasms.

Hepatic Artery↗
PubMed1975

[Indirect (arterial) splenoportography and portography in intraphepatic block].

Morphology and flow dynamics in the lieno-mesentericoportal territory were investigated in 15 normal persons and 199 patients with pre/intra and intra-hepatic blocks. Indirect (arterial) splenoportography with selective catherization of the splenic artery provided angiograms varying between good and diagnostically useful in 98% of cases. With injection into the truncus coeliacus, this figure falls to 77%. The various types of collateral circulation are stated and discussed. The scope and limits of the methods are shown by comparative surveys between direct splenoportography and indirect splenoportography and portography, using 16 patients. As far as the chronological sequence of angiographical diagnostics in the intrahepatic block is concerned, the indirect method shall precede direct splenoportography, which shall only be employed if the indirect method of examination does not provide sufficient information, the patient has shunt capacity and an operation is to be performed immediately.

Adult↗
PubMed1979

[A comparative diagnostic study of malignant lesions of the liver by infusion angiography and percutaneous transhepatic portography (author's transl)].

The diagnostic effectiveness of percutaneous transhepatic portography (PTP) was evaluated in 21 patients with primary and metastatic liver carcinoma, who also had infusion hepatic angiography. The findings at PTP were compared with unequivocal tumor changes demonstrated at infusion hepatic angiography in all cases. PTP revealed tumors in 14 of 21 cases. The location, size and number of the tumor(s) were decisive for their detectability at PTP. Solitary lesions smaller than 2 cm in the central parts of the liver escaped detection, whereas lesions larger than 7 cm in the left lobe and 6 cm in the right lobe were demonstrated in all cases. Multiple metastases of 1--2 cm were detected in most cases. Lesions smaller than 4 cm were better shown by the sinusoidal phase at PTP, where lesions larger than 5 cm were better delineated by the portal venous phase.

Adult↗
PubMed1998

[MRI, CT and CT arterial portography in the diagnosis of malignant liver tumors in liver cirrhosis].

PURPOSE: To determine the value of magnetic resonance imaging (MRI), computed tomography (CT) and CT arterial portography (CTAP) in detecting malignant liver lesions in cirrhosis patients. MATERIALS AND METHODS: The radiological examinations (CT, MRI and CTAP) of 47 patients suffering from cirrhosis having undergone an orthotopic liver transplantation (OLTX) were analysed retrospectively. The number of detected liver lesions was compared with the results of the histopathological findings after OLTX. RESULTS: 13/21, 11/18 and 7/12 of the malignant lesions were detected by MRI, CT and CTAP respectively. In MRI one false positive case was shown, two in CT and three in CTAP. Almost the same lesions were identified by all three procedures. The examination of the liver with MRI and CT and CTAP did not bring additional information. Most of the lesions that were missed were less than 2 cm in diameter. CONCLUSIONS: The rate of detection of HCC in patients with cirrhosis was about 60%. MRI and CT yielded similar results.

Adult↗
PubMed1996

[Triphasic spiral CT in the diagnosis of liver diseases: comparison with CT arteriography and CT arterio-portography].

PURPOSE: Assessment of the diagnostic efficacy of triphasic spiral-CT scanning (TPS-CT) for liver disease evaluation. CT arteriography (CTA) and CT arterio-portography (CTAP) were used as reference, methods which together have the highest sensitivity for detecting tumours and the perfusion conditions of the liver. MATERIAL AND METHODS: 50 TPS-CT and CTA/CTPA were performed in 49 patients. After an initial examination without enhancement the first scan was initiated 15-25s after the peripheral bolus injection of contrast medium, the second after an interscan delay of 20-25s. By this means the liver was imaged in different phases of perfusion. In the course of the CTA/CTPA-exam the imaging was carried out after selective, intraarterial application of contrast agent. RESULTS: The differentiation of the perfusion phases succeeded in 90% of the patients. When compared with standard CT, which images only the portal venous phase, the new technique, which additionally shows the arterial perfusion, accomplished an increase in sensitivity for hypervascular lesions (51% vs. 60%). Yet in comparison with CTA/CTPA fewer lesions could be detected (87 vs. 138). Furthermore, by documenting the contrast agent kinetics, characterisation of the lesion was also facilitated. CONCLUSION: DPS-CT is a valuable additional tool for imaging the liver, even if the information yield is less when compared to CTA/CTPA.

Adult↗
PubMed1988

Total hepatofugal portal blood flow in cirrhosis demonstrated by transhepatic portography.

We investigated 108 patients with cirrhosis of the liver and portal hypertension by percutaneous transhepatic portography to demonstrate the occurrence and frequency of total hepatofugal portal blood flow. Sixteen patients (14.8%) had a total hepatofugal portal blood flow. The aetiology of portal hypertension and the portal pressure did not differ from that in the group of patients with hepatopetal portal blood flow. A significantly higher percentage of patients in the group with hepatofugal flow had gastro-oesophageal varices (P less than 0.025). All patients with varices had bled. Half of the patients in the group with hepatofugal blood flow had a false splenoportographic diagnosis of portal vein thrombosis. In conclusion, total hepatofugal postal blood flow exists more often than hitherto assumed. Hepatofugal blood flow does not relieve portal hypertension nor prevent development of gastrooesophageal varices or bleeding.

Adult↗
PubMed2000

Diagnostic accuracy of helical CT arterial portography and CT hepatic arteriography for hypervascular hepatocellular carcinoma in chronic liver damage. An ROC analysis.

PURPOSE: To evaluate the detectability of hypervascular hepatocellular carcinomas (HCCs) in chronic liver damage with helical CT arterial portography (CTAP) and CT hepatic arteriography (CTHA). MATERIAL AND METHODS: Thirty-nine HCC patients who underwent CTAP and CTHA were studied. Diagnostic abilities of CTAP alone, CTHA alone, or combined CTAP and CTHA were evaluated by receiver operating characteristic (ROC) analysis. Fifty-three images with 53 HCC nodules were evaluated. Tumor size ranged from 5 to 90 mm (mean 22.8 mm). Sensitivities and specificities for all techniques were calculated. RESULTS: ROC analysis showed the diagnostic ability significantly better with combined CTAP and CTHA (mean area under the ROC curve (Az)=0.95), or CTHA alone (Az=0.93) than CTAP alone (Az=0.87) (p<0.01). Combined CTAP and CTHA showed the best sensitivity (95.0%), followed by CTHA alone (88.1%) and CTAP alone (85.5%). The specificities of all three imaging techniques were relatively low (54.1% for combined CTAP and CTHA, 71.1% for CTHA alone, and 54.1% for CTAP alone) because of perfusion abnormalities of the liver parenchyma. CONCLUSION: The combination of CTAP and CTHA is superior to CTAP alone for detection of hypervascular HCCs. However, its specificity was relatively low in chronic liver damage.

Aged↗
PubMed1997

CT arterial portography and CT arteriography with a triple-lumen balloon catheter.

PURPOSE: To evaluate the usefulness of the triple-lumen balloon catheter in the serial performance of CT arterial portography (CT-AP) and CT arteriography (CT-A). MATERIAL AND METHODS: A combined CT-AP and CT-A examination of 58 patients was carried out in which a cobra-type triple-lumen balloon catheter was used. CT-AP was performed by injecting contrast medium either into the splenic artery through a side-hole in the catheter proximal to the balloon inflated in the common hepatic artery, or into the superior mesenteric artery through an end-hole in the catheter. Then CT-A was serially performed by delivering contrast medium either to the common hepatic artery or the proper hepatic artery from the end-hole, or to the accessory right hepatic artery through a side-hole proximal to the inflated balloon. RESULTS: Sufficient CT-APs were obtained in 53 of the 58 patients (91%), CT-A in 42 (72%), and both in 42 (72%). Incomplete CT-AP was due to technical failure or anatomical anomaly, as was incomplete CT-A. No complications were seen. CONCLUSION: The triple-lumen balloon catheter technique is useful and convenient in the serial performance of CT-AP and CT-A.

Carcinoma, Hepatocellular↗
PubMed2000

Highly enhanced hepatic masses seen on CT during arterial portography: early hepatocellular carcinoma and adenomatous hyperplasia.

BACKGROUND: To describe computed tomographic (CT) features of highly enhanced hepatic masses as seen on CT during arterial portography (CTAP) and to survey the varieties of hepatic lesions associated with such findings. METHODS: CTAP files for 400 patients were reviewed, on the basis of which six patients with highly enhanced hepatic masses were selected. These six patients also subsequently underwent CT during hepatic arteriography (CTHA) on the same day. All the patients had chronic liver damage, which was cirrhotic in five cases. Five had a current diagnosis and one had a history of hepatocellular carcinoma (HCC). RESULTS: Solitary highly enhanced masses were observed on CTAP in three patients, three masses were seen in one patient and multiple (10-12) masses in the other two patients. All the CTAP-enhanced masses except one were round in shape and homogeneous in attenuation. The size of the mass ranged from 6 to 25 mm in diameter. In all except two nodules in one patient, the masses were hypoattenuated on CTHA. On histopathological examination of five nodules in three patients, the nodular lesions were consistent with so-called early HCC (well-differentiated HCC of Edmondson I) in four nodules and adenomatous hyperplasia in the other nodule. CONCLUSIONS: Highly enhanced hepatic masses relative to the surrounding liver parenchyma have been sporadically noted on CTAP, especially in patients with liver cirrhosis. When present, such nodules are typically hypoattenuated on CTHA and histological features are consistent with early HCC and adenomatous hyperplasia.

Adenoma↗
PubMed1994

Spiral computed tomography arterial portography with three-dimensional volumetric rendering for oncologic surgery planning. A retrospective analysis.

RATIONALE AND OBJECTIVES: Surgical resection of metastatic neoplasms of the liver can prolong survival of patients. The decision to resect a tumor depends to a great extent on the location of lesions relative to hepatic vasculature. Spiral computed tomography arterial portography (SCTAP) is an excellent technique for preoperative localization of tumors. The addition of three-dimensional rendering of image data sets should enhance the efficiency and accuracy of the interpretation of these data by the surgeon. METHODS: Fourteen patients with surgically and pathologically proven solitary and multiple metastatic hepatic neoplasms underwent SCTAP: Volume data sets thus derived were used to produce life-like three-dimensional animated images through a process known as volumetric rendering. These images were presented to the surgeon, who evaluated them based on several criteria. RESULTS: Accurate and clinically useful images were produced routinely in 13 of 14 patients. CONCLUSIONS: Clinical utility of three-dimensional rendering of SCTAP data sets for preoperative localization of hepatic lesions has been shown retrospectively. A larger, prospective study is suggested to demonstrate the accuracy and efficacy of the technique.

Adult↗
PubMed2001

Radiologic anatomy of the rabbit liver on hepatic venography, arteriography, portography, and cholangiography.

UNLABELLED: Seo TS, Oh JH, Lee DH, et al. Radiologic anatomy of the rabbit liver on hepatic venography, arteriography, portography, and cholangiography. Invest Radiol 2001;36:186-192. RATIONALE AND OBJECTIVES: The radiologic anatomy of rabbit liver has received little study but is important in many experimental investigations. METHODS: Twenty-four rabbits were studied by using hepatic venograms, aortograms, hepatic arteriograms, cholangiograms, and portograms. RESULTS: In all cases, the right, middle, and left hepatic veins drained into the inferior vena cava just below the diaphragm, and the caudate lobe hepatic vein drained more inferiorly. The proper hepatic artery was a branch of the common hepatic artery in 96%. The first branch of the proper hepatic artery was the caudate lobe artery. The remaining main hepatic artery was divided into the right and left hepatic arteries. The left hepatic artery was further divided into the medial and lateral segmental branches in 95%. The anatomy of the portal vein or bile duct was the same as the hepatic artery in 100% of cases. CONCLUSIONS: Knowledge of the normal patterns and variations of the vessels and bile duct will be helpful for experiments of the rabbit liver in future studies.

Animals↗