Computed tomography during arterial portography under temporary balloon occlusion of the hepatic artery: evaluation of pseudolesions caused by arterio-portal venous shunts.
BACKGROUND
Computed tomography during arterial portography (CTAP) under temporary balloon occlusion of the hepatic artery (BOHA-CTAP) was introduced to evaluate pseudolesions caused by portal venous impairments such as arterioportal shunt and tumor thrombus.


METHODS
BOHA-CTAP was performed in seven patients with hepatocellular carcinoma and correlated with clinical outcomes. For patients with wedge-shaped defects suggestive of pseudolesions, BOHA-CTAP was obtained by a 5-F balloon occlusion catheter into the proper hepatic artery through the second 5-F introducer inserted into the common femoral artery a few centimeters below the first 5-F sheath for CTAP.


RESULTS
Eight pseudolesions were determined clinically on follow-up CT, ultrasonography, or magnetic resonance imagings. On BOHA-CTAP, five of the eight pseudolesions were eliminated, and two were diminished in comparision with conventional CTAP. One wedge-shaped defect due to tumor thrombus in the portal vein did not show any change.


CONCLUSIONS
BOHA-CTAP can reduce pseudolesions caused by portal venous impairments and enable the demarcation of the true tumors.
Koizumi
J
J
Department of Diagnostic Radiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Kurata
T
T
Yamashita
T
T
Kominami
M
M
Fujiwara
H
H
Narimatsu
Y
Y
Hiramatsu
K
K
D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011172:Portography; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging