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간 혈류동태학적 변화의 나선형 간동맥조영 CT 및 문맥조영 CT 소견에 의한 유형 분석
지금난 대한영상의학회 1996 대한영상의학회지 Vol.35 No.5
Purpose : To evaluate the patterns of hemodynamic changes caused by various pathologic liver conditions.Materials & Methods : Combined CT hepatic arteriography(CTHA) and CT arterial portography(CTAP), performed in 185consecutive patients, including 150 with hepatocellular carcinoma, were retrospectively analysed. Of thesepatients, 48 showed various patterns of hemodynamic change. such change caused by occlusion, stenosis and\orcavernous transformation of the portal vein, by occlusion or stenosis of the hepatic artery, or by the presence ofarterioportal(AP) shunt could be classified as follows : type 1, decreased or absent portal flow ; type 2,decreased or absent hepatic arterial flow ; type 3, AP shunt without portal tumor thrombus(PTT) ; and type 4, PTTwith transvasal AP shunt, including the presence of cavernous transformation of the portal vein. Results : Type I(n=20) showed hyperattenuation of both PTT and absent portal flow area on CTHA, and reciprocally consistenthypoattenuation on CTAP. Type II (n=6) showed a hypoattenuating area on CTHA, and isoattenuation or slightlyhyperattenuation on CTAP. Type III (n=9) showed an oval or wedge-shaped hyperattenuating area on CTHA, anddefective perfusion at the same area on CTAP. In Type IV (n=13), both CTHA and CTAP showed variable findings,according to the amount of transvasal AP shunt, the location and extent of PTT, and/or cavernous transformation ofthe portal vein. Conclusion : Pattern analyses of hemodynamic changes on both CTHA and CTAP are helpful inclarifying the primary causes of hemodynamic changes in the liver.
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이중시기(Dual-phase)나선식 CT에서 비장의 크기와 간문맥의 조영증강과의 상관성 연구
안승언 대한영상의학회 1996 대한영상의학회지 Vol.35 No.4
Purpose : To evaluate using spiral CT the effect of spleen size on blood flow in the portal venous system andto know the usefulness of this evaluation.. Materials and Methods : Fifty-one patients without evidence on spiralCT scan of abnormality thought to affect portal venous flow presented between December 1994 and June 1995. Wemeasured spleen size and Hounsfield units of portal vein in dual-phase, and calculated the ratio of the unit inthe portal phase to that in the arterial phase. Spleen size was measured, using the length of X-axis by that ofZ-axis on spiral CT scan. We then measured the correlation between the two values. CT was performed with a SomatomPlus-S scanner(Siemens, Erlangen, Germany). A total dose of 120ml of non-ionic contrast material(Ultravist) wasadministered at a rate of 3ml/sec. Arterial and portal phase were obtained after 30 seconds and 60 seconds fromthe beginning of the contrast agent injection. Results : The correlation between spleen size and contrastenhancement of the portal vein was relatively significant(Pearson's correlation coefficient(r)=0.41801).Conclusions : Spleen size significantly affects portal venous flow on spiral CT scan. The evaluation of spleensize and contrast enhancement of the portal vein could be useful in the differential diagnosis of diseases whichaffect portal venous flow.
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