Hemodynamic and morphologic changes after portal vein embolization: differential effects in central and peripheral zones in the liver on multiphasic computed tomography.
OBJECTIVE
To evaluate hemodynamic and morphologic effects in the liver after portal vein embolization (PVE).


METHODS
Hepatic computed tomography scans of 7 patients who had undergone preoperative PVE were retrospectively reviewed. Pre- and post-PVE computed tomography densities were evaluated for the unenhanced, late arterial, and portal venous phases in peripheral and central hepatic regions and in the 3 main hepatic veins. Relative changes in areas in these regions were assessed in 5 evaluable patients with serial post-PVE scans.


RESULTS
During the late arterial phase, enhancement was significantly higher after PVE than it was before PVE in the peripheral hepatic regions, and it was higher in the peripheral regions than in the central regions. Enhancement was also significantly higher in the right main hepatic vein than in the middle and left hepatic veins during the late arterial phase. The ratio of areas of the peripheral/central regions decreased significantly after PVE.


CONCLUSIONS
Zonal enhancement in the late arterial phase changed after PVE and seemed to be associated with differential parenchymal atrophy. We speculate that the hepatic arterial supply increases peripherally and that peribiliary/periportal plexuses maintain the portal supply centrally.
Kobayashi
Satoshi
S
Department of Diagnostic Radiology, Unit 057, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA.
Ng
Chaan S
CS
Kazama
Toshiki
T
Madoff
David C
DC
Faria
Silvana C
SC
Vauthey
Jean N
JN
Charnsangavej
Chusilp
C
D015502:Absorptiometry, Photon; D000368:Aged; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging*; D008102:Liver Circulation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media