Haemodynamic changes in the liver under balloon occlusion of a portal vein branch—evaluation with single-level dynamic computed tomography during hepatic arteriography

Komada, Y.; Murata, S.; Tajima, H.; Kumita, S.; Kanazawa, H.; Tajiri, T.

doi:10.1016/j.crad.2007.01.012

« Previous Next »Clinical Radiology
Volume 62, Issue 6 , Pages 579-586, June 2007

Haemodynamic changes in the liver under balloon occlusion of a portal vein branch—evaluation with single-level dynamic computed tomography during hepatic arteriography

Y. Komada
- Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo, Japan
- Guarantor and correspondent: Y. Komada, Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. Tel.: +81 3 5814 6240; fax: +81 3 5685 1795.
S. Murata
- Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo, Japan
H. Tajima
- Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo, Japan
S. Kumita
- Department of Radiology/Center for Advanced Medical Technology, Sendagi, Bunkyo-ku, Tokyo, Japan
H. Kanazawa
- 3rd Department of Internal Medicine, Sendagi, Bunkyo-ku, Tokyo, Japan
T. Tajiri
- 1st Department of Surgery, Nippon Medical School, Sendagi, Bunkyo-ku, Tokyo, Japan

Received 23 September 2006; received in revised form 23 December 2006; accepted 11 January 2007.

Aim

To assess haemodynamic changes in the liver under temporary occlusion of an intrahepatic portal vein.

Materials and methods

Between February 2000 and October 2004, 16 patients with hepatobiliary disease underwent single-level dynamic computed tomography during hepatic arteriography (SLD-CTHA) under temporary balloon occlusion of an intrahepatic portal vein. All patients needed percutaneous transhepatic portography for therapy of their disease. SLD-CTHA was undertaken to clarify the time–attenuation curve influenced by portal vein occlusion, and it was performed continuously over a period of 30s. The difference in absolute attenuation of the liver parenchyma in segments with occluded and non-occluded portal vein branches was determined by means of the CT number, and the difference in absolute attenuation of the occluded and non-occluded portal veins themselves was also evaluated.

Results

SLD-CTHA demonstrated a demarcated hyperattenuation area in the corresponding distribution of the occluded portal vein branch. The attenuation of the liver parenchyma supplied by the occluded portal vein was significantly higher than that in the non-occluded area (p<0.01). The balloon-occluded portal branch enhancement in 15 of 16 cases (94%) appears due to arterio-portal communications. Failure to evaluate a remaining case for portal branch enhancement was due to absence of a visualized portal branch in the section.

Conclusion

Under temporary occlusion of an intrahepatic portal vein, hepatic angiography produced enhancement of the occluded portal branches and their corresponding parenchymal distribution; this finding is considered consistent with the presence of arterio-portal communications.