Computed tomography arterial portography for assessment of portal vein injury after blunt hepatic trauma.
OBJECTIVE
Intrahepatic portal vein injuries secondary to blunt abdominal trauma are difficult to diagnose and can result in insidious bleeding. We aimed to compare computed tomography arterial portography (CTAP), reperfusion CTAP (rCTAP), and conventional computed tomography (CT) for diagnosing portal vein injuries after blunt hepatic trauma.


METHODS
Patients with blunt hepatic trauma, who were eligible for nonoperative management, underwent CTAP, rCTAP, and CT. The number and size of perfusion defects observed using the three methods were compared.


RESULTS
A total of 13 patients (seven males/six females) with a mean age of 34.5±14.1 years were included in the study. A total of 36 hepatic segments had perfusion defects on rCTAP and CT, while there were 47 hepatic segments with perfusion defects on CTAP. The size of perfusion defects on CT (239 cm3; interquartile range [IQR]: 129.5, 309.5) and rCTAP (238 cm3; IQR: 129.5, 310.5) were significantly smaller compared with CTAP (291 cm3; IQR: 136, 371) (both, P = 0.002).


CONCLUSIONS
Perfusion defects measured by CTAP were significantly greater than those determined by either rCTAP or CT in cases of blunt hepatic trauma. This finding suggests that CTAP is superior to rCTAP and CT in evaluating portal vein injuries after blunt liver trauma.
Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, TaoYuan, Taiwan. b2401003@gmail.com.
Chen Ju
CJ
Fu
Yon Cheong
YC
Wong
Yuk Ming
YM
Tsang
Li Jen
LJ
Wang
Huan Wu
HW
Chen
Yi Kang
YK
Ku
Cheng Hsien
CH
Wu
Huan Wen
HW
Chen
Shih Ching
SC
Kang
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D011172:Portography; D015424:Reperfusion / Q000379:methods; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*; D055815:Young Adult