Diagnosis of cirrhotic portal hypertension and compensatory circulation using transsplenic portal scintigraphy with (99m)Tc-phytate.
Our objective was to investigate the diagnostic value and clinical significance of transsplenic portal scintigraphy in cirrhotic portal hypertension and compensatory circulation.


METHODS
Transsplenic portal scintigraphy, ultrasound, and gastroscopy were performed on 50 patients with cirrhotic portal hypertension and on 10 controls. According to the Child-Pugh classification, 15 patients with cirrhosis were Child A, 19 were Child B, and 16 were Child C.


RESULTS
In the control group, the splenoportal vein was shaped like the letter S, and the portosystemic shunt index was 0.19 +/- 0.07. Portal hypertension portosystemic shunts were of 3 types: intrahepatic (13 patients; index, 0.52 +/- 0.19), compensatory (31 patients; index, 0.64 +/- 0.28); and completely extrahepatic (6 patients; index, 0.91 +/- 0.03). Collateral vessels were uphill, downhill, or complex. The portosystemic shunt index increased as cirrhosis and esophageal varices increased. There was statistical significance among groups (P < 0.05 or < 0.01).


CONCLUSIONS
Transsplenic portal scintigraphy was sensitive for detecting the number and location of shunts and will allow for improved surgical planning.
Gao
Li
L
Department of Nuclear Medicine, Qilu Hospital of Shandong University, Jinan 250012, China.
Yang
Fuyong
F
Ren
Changzheng
C
Han
Jiankui
J
Zhao
Youan
Y
Li
Hua
H
D000368:Aged; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D007091:Image Processing, Computer-Assisted; D008026:Ligation; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010833:Phytic Acid; D011169:Portal Vein / Q000000981:diagnostic imaging; D011170:Portasystemic Shunt, Surgical; D019275:Radiopharmaceuticals; D013154:Spleen / Q000000981:diagnostic imaging*; D013162:Splenic Vein / Q000000981:diagnostic imaging / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C026177:technetium phytate; D010833:Phytic Acid