Value of Spiral CT in Assessing Portal Hypertension

Objective To evaluate spiral CT portography (CTP) in demonstrating portal system and its collateral in portal hypertension. Materials and Methods Both spiral CT portography and conventional portography were performed in 51 patients with HCC and/or cirrhosis complicated by portal hypertension. The patency of the main portal vein and its right and left branches were observed. The distribution and extent of the collateral were also assessed. CTP findings were compared with the results of conventional portography, which included percutaneous transhepatic portography, transsplenic vein portography, transjugular intrahepatic portography and transarterial indirect portography.Results Of 153 portal veins and branches demonstrated in 51 patients, 107 were patent and 46 obstructed. On CTP, 104 out of 107 patent portal veins and 44 out of 46 obstructed portal veins were displayed, with a coincidence rate of 96.7% (148/153). CTP well displayed the collateral, with a coincidence rate of 95.3% (41/43).Conclusion When combined with conventional portography, CTP can precisely demonstrate the patency of portal veins and the presence of collateral in portal hypertension in high agreement with conventional portography. Basically, CTP can replace the invasive conventional portography.