Hepatofugal portal flow in advanced liver cirrhosis with spontaneous portosystemic shunts: effects on parenchymal hepatic enhancement at dual-phase helical CT.
BACKGROUND
We investigated whether spontaneous hepatofugal portal flow in advanced cirrhosis affects hepatic enhancement on dual-phase helical computed tomography.


METHODS
Fifteen patients with hepatofugal portal flow on Doppler sonography and angiography (group 1) and 15 age- and sex-matched patients with hepatopetal portal flow (control; group 2) underwent dual-phase helical computed tomography. Vascular and liver attenuation values were measured on unenhanced scans and scans obtained during hepatic arterial (HAP; 25 s) and portal venous (PVP; 70 s) phases.


RESULTS
Portal vein enhancement was lower during PVP in group 1 than in group 2 ( p < 0.0001). Liver enhancement was higher during HAP and lower and delayed during PVP in group 1 versus group 2 ( p < 0.0001).


CONCLUSIONS
In hepatofugal portal flow, liver enhancement is increased during HAP and compensating for decreased and delayed liver enhancement during PVP, resulting in potential decreased hypervascular tumor conspicuity.
Vignaux
O
O
Department of Radiology, Université René Descartes, Hôpital Cochin, 27 rue du Fg Saint Jacques, 75679 Paris Cedex 14, France.
Gouya
H
H
Augui
J
J
Oudjit
A
A
Coste
J
J
Dousset
B
B
Chaussade
S
S
Legmann
P
P
D003097:Collateral Circulation; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology; D008099:Liver / Q000000981:diagnostic imaging*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods