Opacification of Portal Vein on CT during Hepatic Arteriography Via Normal Vascular Flow

ABSTRACT

PURPOSE: To evaluate the frequency, distribution, and associated factors of the opacified normal portal veinas seen on CT, during hepatic arteriography(CTHA). MATERIALS AND METHODS: One hundred and eighty-nine patientswho underwent both CTHA and CT during arterioportography (CTAP) during a three-year period were reviewed. Ofthese, 66 patients without anomalous hepatic arterial supply and arterioportal (AP) shunt on celiac angiographywere analyzed. Comparing CTHA with CTAP, we determined whether or not the portal vein(PV) is opacified within thesecond-order branch. The degree of contrast enhancement in the stomach, duodenum, and pancreas was graded asfollows grade I, all three organs were hypodensely enhanced; grade II, some organ were isodensely enhanced, butothers hypodensely ; grade III, all three organs were isodensely enhanced relative to the CHA. The relationshipbetween opacified portal vein (OPV) and the degree of enhancement of the three organs, amount of contrast media,and Child classification was statistically examined. RESULTS: The PV was opacified in 18 of the 66 patients (27%); This was the main PV in 16, right PV in 13, and left PV in two. Of the single branches, the right post posteriorbranch was most commonly opacified. Among 18 patients with OPV, the degree of three organs (stomach, duodenum, andpancreas) was grade I in two, grade II in two, and grade III in 14 while among 48 patients with nonopacified PV, thefindings were grade I in 27, grade II in seven, and grade III in 14. The relationship between OPV and degree ofenhancement of the three organs was statistically significant (p=0.001). There was however, no statisticallysignificant difference between OPV and Child classification and the amount of contrast media. CONCLUSION: PVopacification during CTHA is not rare and this finding should not therfore be regarded as indicator of apathologic conditions such as AP shunt.