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Radiology. 1994 Dec;193(3):651-5.

Optimizing CT portography: a prospective comparison of injection into the splenic versus superior mesenteric artery.

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1
Department of Radiology, University of Pittsburgh Medical Center, PA 15213-2582.

Abstract

PURPOSE:

To evaluate whether computed tomographic arterial portography (CTAP) is best performed with injections in the superior mesenteric artery (SMA) or the splenic artery.

MATERIALS AND METHODS:

Seventy-one studies were performed with injection into the SMA (n = 37) or splenic artery (n = 34) of 150 mL of contrast material at 1.5 mL/sec and 20-second delay for both groups. Images were reviewed for location and type of nontumoral perfusion abnormalities. The degree of liver parenchymal enhancement with each technique was compared.

RESULTS:

Fewer nontumoral perfusion defects were seen with splenic artery (65%) versus SMA (78%) injection. Visual differences in contrast enhancement with greater attenuation in dependent portions of the liver were seen with greater frequency with SMA (41%) than with splenic artery (24%) injection. Contrast enhancement that obscured detail in the right lobe was seen only with SMA injections (16%). Greater parenchymal enhancement (up to 18 HU) at all time intervals was seen with splenic artery injection.

CONCLUSION:

Because of greater parenchymal enhancement and fewer nontumoral perfusion abnormalities, splenic artery catheterization is the preferred technique for CTAP.

[Indexed for MEDLINE]

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