[Radionuclide angiography (scintiphotosplenovenography) in the evaluation of splenorenal shunt patency].
Radionuclide angiography of the splenic vein (Scintiphotosplenovenography: SSV) was done in 7 patients following a distal splenorenal shunt (Warren procedure). Spleen was punctured with a 22 gauge needle under ultrasonographic guidance. One half ml of 99m TcO4- solution, which contained 10 mci of nuclide energy, was injected into the splenic parenchyma through the needle. Injected material was followed by scintillation camera. In five cases, whose esophageal varices had been endoscopically atrophic, the splenic vein, the left renal vein, the inferior vena cava and the heart were clearly viewed in a continuity within 8 seconds from the start of injection. In one case, whose varices had recurred soon after the operation, only the collaterals were delineated. Most of them seemed running upwards alongside the esophagus. In the remaining patient, whose varices had been atrophic, the splenic vein was faintly delineated within 8 seconds. However, most of the 99m TcO4- stayed at first in the spleen. Thereafter it went out into the collaterals, the lower intercostal vein and the hemiazygos vein. This method is less invasive than the conventional angiography. It can reveal not only the entire imaging of shunt flow but also the collaterals, if they exist. It seemed useful for the evaluation of shunt patency following distal splenorenal shunt.
D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical; D011877:Radionuclide Imaging; D013670:Sodium Pertechnetate Tc 99m; D013162:Splenic Vein / Q000000981:diagnostic imaging*
D013670:Sodium Pertechnetate Tc 99m