3D 16-Detector CT Portography Manifestations of Spontaneous Splenorenal Shunts in Portal Hypertension

Objective To describe the 3D 16-detector CT portography manifestations of spontaneous splenorenal shunts in portal hypertension and to discuss the role of 3D 16-detector CT in the management of gastric varices. Materials and Methods Enhanced CT scan was performed in 211 patients with suspected of portal hypertention, and 3D CT portography was reconstructed in postprocessing work station. Results Spontaneous splenorenal shunts were seen in 63 cases, of which, the main trunk of splenic venal or one of its branches connects directly with the left renal vein in 14 cases, short gastric vein and posterior gastric vein in the posterior aspect of the fundus of the stomach in 9 cases, left gastric vein through the inferior diaphragm or the retropancreatic space in 63 cases, and others in 2 cases. Conclusion 3D 16-detector CT portography has excellent capability to demonstrate spontaneous splenorenal shunts in 3D relationships by multiple directions. The spontaneous splenorenal shunts are divided into four types, which are useful for selecting patients, planning procedure, and eventually evaluating the results.