PERCUTANEOUS TRANSHEPATIC CATHETERIZATION OF PORTAL-VEIN FOR STUDY OF PORTAL HEMODYNAMICS AND SHUNTS - PRELIMINARY-REPORT

Abstract

A technique for catheterizing the portal vein transhepatically, based on a method for percutaneous transhepatic cholangiography, is described. Using this technique, quantitation of the intrahepatic shunt and extrahepatic shunt from the splenoportal axis is possible. It involves injection of 99mTc-macroaggregated albumin into the splenic vein at the splenic hilum and 131I-macroaggregated albumin into the portal trunk, followed by differential counting over predetermined areas of the liver and lungs. Catheterization was successful in 20 of 30 patients [with cirrhosis, portal hypertension, steatosis and hepatitis] in whom it was attempted. The intrahepatic shunt indices varied from 1.0-78.4%, and the extrahepatic shunt indices ranged from 0-49.9%. These values appeared to correlate closely with the size of collaterals opacified by portography.