title: Diagnosis of cirrhotic portal hypertension and compensatory circulation using transsplenic portal scintigraphy with (99m)Tc-phytate.
abstract: 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.
authors.affiliation: Department of Nuclear Medicine, Qilu Hospital of Shandong University, Jinan 250012, China.
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Fuyong
authors.initials: F
authors.lastname: Yang
authors.forename: Changzheng
authors.initials: C
authors.lastname: Ren
authors.forename: Jiankui
authors.initials: J
authors.lastname: Han
authors.forename: Youan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Hua
authors.initials: H
authors.lastname: Li
mesh_terms: 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
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C026177:technetium phytate; D010833:Phytic Acid