title: Saline-enhanced ultrasonography: prediction of X-ray appearance of hepatic venography in patients with cirrhosis.
abstract: OBJECTIVE
  To examine the efficacy of saline-enhanced ultrasound (US) in predicting the X-ray appearance of hepatic venography.
  
  
  METHODS
  This prospective study consisted of 50 cirrhosis patients (31 males and 19 females; mean age, 64.2±11.1 years). US patterns in the liver, after injection of agitated saline via balloon-occluded catheter, were evaluated with respect to the findings of CO2-enhanced hepatic venogram.
  
  
  RESULTS
  US demonstrated two patterns: type I showing positive parenchymal enhancement (40 patients) and type II showing negative parenchymal enhancement with detection of hepatic vein (10 patients). There were also two patterns shown by hepatic venography: type A showing retrograde detection of intrahepatic portal vein (41 patients) and type B showing hepatic venous enhancement via intrahepatic venous-venous communications with no detection of intrahepatic portal vein (9 patients). All patients with type I showed retrograde detection of intrahepatic portal vein via hepatic sinusoid on X-ray venograms (type A). Of the 10 patients with type II, nine showed type B and one showed type A. Sensitivity and specificity of type I US pattern to predict the detection of intrahepatic portal vein on the venogram were 100% and 90%, respectively. There was no significant difference in hepatic venous pressure gradient or wedged hepatic venous pressure between patients with type I and type II.
  
  
  CONCLUSIONS
  Saline-enhanced US is effective in predicting the findings of hepatic venogram. As type II strongly suggests the shunt-modified venogram, image taking in these cases would be superfluous with the added advantage of avoiding unnecessary radiation exposure.
authors.affiliation: Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine , Chiba , Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kiyono
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kamesaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kondo
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sekimoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012965:Sodium Chloride; D014463:Ultrasonography; D016157:Vascular Fistula / Q000000981:diagnostic imaging*; D014690:Venous Pressure
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride