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Change in Portal Vein Hemodynamics After Chemoembolization for Hepatocellular Carcinoma

Evaluation Through Multilevel Dynamic Multidetector Computed Tomography During Arterial Portography

Murotani, Kazuhiro RT; Nakai, Motoki MD; Sato, Morio MD; Minamiguchi, Hiroki MD; Sonomura, Tetsuo MD; Hosokawa, Seiki RT; Nishioku, Tadayoshi RT

Journal of Computer Assisted Tomography: May/June 2015 - Volume 39 - Issue 3 - p 396–400
doi: 10.1097/RCT.0000000000000229
Abdominal Imaging
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Objective This study aimed to clarify the effect of embolization with lipiodol on portal vein hemodynamics.

Methods Time-density curves of the main portal vein on multilevel dynamic multidetector computed tomography during arterial portography were used to analyze peak computed tomography value (PV), time to PV (TPV), arrival time of contrast medium at the main portal vein (ATMPV), slope [(PV − 150) / (TPV − ATMPV)], and slope ratio (slope after embolization / slope before embolization).

Results In 20 patients with hepatoma, ATMPV and TPV were significantly prolonged and the time-density curve slope was significantly less after embolization. The difference in TPV increased (P = 0.02) and the slope ratio decreased with increasing embolized volume rate (P < 0.001). Strong correlation (R = −0.86) was found between the slope ratio and the embolized volume rate.

Conclusions Time-density curves revealed significant portal vein flow delay after embolization; the degree of which was correlated with the extent of the embolized volume.

From the Department of Radiology, Wakayama Medical University, Wakayama, Japan.

Received for publication October 27, 2014; accepted January 7, 2015.

Reprints: Morio Sato MD, Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8510, Japan (e-mail: morisato@wakayama-med.ac.jp).

The authors declare no conflict of interest.

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