Zebra Pattern in CT during Arterial Portography: Analysis of Associated Factors

ABSTRACT

PURPOSE: To analyze the factors associated with the zebra pattern in CT during arterial portography(CTAP). MATERIALS AND METHODS: In 275 CTAP procedures, the factors associated with the zebra pattern, such as laminar flow in the portal vein, the presence of liver cirrhosis, the artery selected for CTAP, location of the catheter tip in the superior mesenteric artery(SMA), splenic volume, and the existence of an aberrant right hepatic artery(RHA) emerging from the SMA were analyzed. RESULTS: In 106 of 275 procedures (38.5%), a zebra pattern was apparent. Portal venous laminal flow was seen in 92 % of procedures in the group with this pattern and in 63 % in the group without it. Eighty-three of 235 procedures (35.3 %) in which the SMA was injected and 23 of 40(57.5 %) involving splenic artery injection showed the zebra pattern. In 22 of 35(62.8 %) in which the catheter tip was located in the distal SMA and 61 of 200 ( 30.5 %) in which this was at a proximal site, the zebra pattern was evident. Mean splenic volume was less in the group with the zebra pattern. The effect on the zebra pattern of liver cirrhosis and an aberrant RHA emerging from the SMA was not statistically significant. CONCLUSION: In CTAP, the incidence of the zebra pattern was 38.6%, and was related to laminal flow in the portal vein. The pattern is frequently seen in CTAP involving contrast injection via the splenic artery, distal location of a catheter tip in the SMA, and small splenic volume.