title: Usefulness of portography and contrast-enhanced computed tomography to predict the embolized area in percutaneous transhepatic portal vein embolization with absolute ethanol under temporary balloon occlusion.
abstract: OBJECTIVE
  To assess the usefulness of portography and contrast-enhanced computed tomography (CECT) for predicting the embolized area after the first injection of absolute ethanol (AE) in right portal vein embolization (RPVE).
  
  
  METHODS
  Portograms were retrospectively reviewed in 50 patients (30 men and 20 women, mean age 65 years) who had undergone percutaneous transhepatic RPVE with AE under temporary balloon occlusion (TBO) between February 2002 and October 2009. The enhancement pattern before embolization and the embolization pattern after the first AE injection were analyzed by portography. The angles of portal branches against the horizontal plane were measured in 48 patients using pre-treatment CECT.
  
  
  RESULTS
  The enhancement pattern was not consistent with the embolization pattern in 35 patients (p < 0.001). When the anterior branch angles were divided into two groups at -5°, 0°, 10°, and 15°, the frequency of the posterior-branch-dominant embolization pattern was higher in the more negatively angled group (p = 0.002-0.041).
  
  
  CONCLUSIONS
  The distribution of AE is different from that of contrast medium in percutaneous transhepatic RPVE under TBO. The pre-treatment measurement of the angles of portal branches against the horizontal plane on CECT is suggested to be useful for predicting the embolized area.
authors.affiliation: Department of Radiology, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo 060-8638, Japan. yhasegawa@med.hokudai.ac.jp
authors.forename: Yu
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Abo
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sakuhara
authors.forename: Fumi
authors.initials: F
authors.lastname: Kato
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kamishimma
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shimizu
authors.forename: Yoichi M
authors.initials: YM
authors.lastname: Ito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Terae
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
mesh_terms: D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007472:Iohexol; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011172:Portography / Q000379:methods; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012997:Solvents / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D012997:Solvents; D000431:Ethanol; D007472:Iohexol