title: Value of intraarterial prostaglandin E(1) injection during CT hepatic arteriography.
abstract: OBJECTIVE
  The purpose of our investigation was to determine if injection of prostaglandin E(1) during CT hepatic arteriography could help physicians to distinguish tumors from nonportal venous flow-related pseudolesions in the region of the gallbladder fossa.
  
  
  METHODS
  In 34 patients who underwent CT during arterial portography to detect liver tumors, CT hepatic arteriography was performed before and after prostaglandin E(1) injection via the superior mesenteric artery. Between each study, an interval of 10 minutes was set. On CT hepatic arteriogram obtained 15 to 20 sec after prostaglandin E(1) injection, we distinguished changes in the size and shape of pseudolesions in the liver around the gallbladder as well as those of 42 tumorous lesions. In addition, we measured the change in CT attenuation of pseudolesions.
  
  
  RESULTS
  The size of the enhanced area of pseudolesions visible on CT hepatic arteriography decreased in 69% (25/36) of the pseudolesions after intraarterial prostaglandin E(1) injection, with the mean diameter diminishing from 14.1 mm to 8.8 mm. Notably, in 11 pseudolesions, the enhanced area disappeared. In 86% (31/36), the CT attenuation decreased with the mean attenuation, diminishing from 211.3 H to 163.8 H. However, the size and shape of the enhanced area of tumorous lesions did not change.
  
  
  CONCLUSIONS
  The hemodynamic features of pseudolesions on angiographically assisted helical CT scans caused by cholecystic venous inflow are easily influenced by increased portal venous flow. Consequently, pseudolesions around the gallbladder usually can be distinguished from tumorous lesions by adding prostaglandin E(1) injection via the superior mesenteric artery during CT hepatic arteriography.
authors: Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajii, Kawaramachi-Hirokoji, Kamigyo, Kyoto, 602-8566, Japan.
authors: T
authors: T
authors: Yamagami
authors: T
authors: T
authors: Nakamura
authors: O
authors: O
authors: Sato
authors: Y
authors: Y
authors: Takeuchi
authors: T
authors: T
authors: Nishimura
mesh_terms: D000527:Alprostadil / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011172:Portography / Q000379:methods; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D000527:Alprostadil