OBJECTIVE: We studied the causes of technical failure and enhancement variability encountered during CT arterial portography. MATERIALS AND METHODS: CT arterial portograms and digital arteriograms were obtained via the superior mesenteric artery before partial liver resection in 43 patients with malignant tumors. These studies were reviewed for causes of technical failure and variable enhancement. RESULTS: Eleven (26%) of 43 procedures were technical failures. Causes of failure included aortic injection after catheter dislodgement (four), dense hyperenhancement associated with laminar flow in the portal vein produced by rapid venous return from a selective injection into a proximal branch vessel of the superior mesenteric artery (two), premature scanning beginning at the iliac crest (two), reflux into a replaced right hepatic artery (one), hepatic arterial enhancement via the pancreaticoduodenal arcade (one), and portal hypertension (one). Of the 32 remaining studies, 28 showed areas of parenchymal hypoenhancement or hyperenhancement. Causes of variable enhancement included impaired portal vein perfusion from mass effect of the tumor, laminar flow in the portal vein, and focal fatty infiltration. CONCLUSION: Technical failures and enhancement variability are common in CT arterial portography. Factors leading to technical failure include catheter choice and position, portal hypertension, and operator error.
OBJECTIVE: We studied the causes of technical failure and enhancement variability encountered during CT arterial portography. MATERIALS AND METHODS: CT arterial portograms and digital arteriograms were obtained via the superior mesenteric artery before partial liver resection in 43 patients with malignant tumors. These studies were reviewed for causes of technical failure and variable enhancement. RESULTS: Eleven (26%) of 43 procedures were technical failures. Causes of failure included aortic injection after catheter dislodgement (four), dense hyperenhancement associated with laminar flow in the portal vein produced by rapid venous return from a selective injection into a proximal branch vessel of the superior mesenteric artery (two), premature scanning beginning at the iliac crest (two), reflux into a replaced right hepatic artery (one), hepatic arterial enhancement via the pancreaticoduodenal arcade (one), and portal hypertension (one). Of the 32 remaining studies, 28 showed areas of parenchymal hypoenhancement or hyperenhancement. Causes of variable enhancement included impaired portal vein perfusion from mass effect of the tumor, laminar flow in the portal vein, and focal fatty infiltration. CONCLUSION: Technical failures and enhancement variability are common in CT arterial portography. Factors leading to technical failure include catheter choice and position, portal hypertension, and operator error.
Authors: Chen Ju Fu; Yon Cheong Wong; Yuk Ming Tsang; Li Jen Wang; Huan Wu Chen; Yi Kang Ku; Cheng Hsien Wu; Huan Wen Chen; Shih Ching Kang Journal: Diagn Interv Radiol Date: 2015 Sep-Oct Impact factor: 2.630
Authors: Renate Hammerstingl; Alexander Huppertz; Josy Breuer; Thomas Balzer; Anthony Blakeborough; Rick Carter; Lluis Castells Fusté; Gertraud Heinz-Peer; Werner Judmaier; Michael Laniado; Riccardo M Manfredi; Didier G Mathieu; Dieter Müller; Koenraad Mortelè; Peter Reimer; Maximilian F Reiser; Philip J Robinson; Kohkan Shamsi; Michael Strotzer; Matthias Taupitz; Bernd Tombach; Gianluca Valeri; Bernhard E van Beers; Thomas J Vogl Journal: Eur Radiol Date: 2007-12-06 Impact factor: 5.315