Clinical significance of imaging in preoperative vascular evaluation for patients with portal hypertension

Objective To compare the clinical significance of color Doppler sonography, spiral CT portography, direct portography and conventional angiographic portography for preoperative evaluation of those patients with portal hypertension. Methods From February 2000 to October 2002, 40 patients with cirrhotic portal hypertension had received color Doppler sonography, spiral CT portography, direct portography and conventional angiographic portography. We studied and compared these imaging methods in display of portal vein flow, thrombi and shunt branch. Results In all the 40 patients, 10%, 12.5%, 12.5% and 12.5% of the portal systemic thromboses were displayed separately in color Doppler sonography, spiral CT portography, direct portography and conventional angiogrphic portography and the display rate of coronary vein was 50%, 100%, 25% and 100% while that of gastris fundus varicosity 50%, 100%, 25% and 100%. Conclusions Color Doppler sonography and direct portography show low display rate of portal systemic branches, especially in coronary vein, but show functional liver plasma flow well. CT and direct portography are better in display of coronary vein and other branches. As means of non-invasive examination, color Doppler sonography and direct portography are of high value for selection of surgical approaches and improvement of therapeutic efficacy for treatment of portal hypertension.