Computed Tomographic Percutaneous Transsplenic Portography

The diagnosis of liver tumors should be utilized for determination of not only the number of lesions, but also their size, segmental location and extent, and the relationship of the mass or masses to the hepatic vasculature. CT during arterial portography (CTAP) is the most sensitive imaging modality for precise diagnosis of hepatocellular carcinoma. CTAP is thus widely used as a diagnostic imaging technique, particularly for the detection of small hepatocellular carcinomas. Conventional splenic portography has been carried out for many years using a wide diameter needle, a large amount of contrast medium and a film-screen system. Since the development of arterial portography, fewer splenoportograms have been performed due to the high incidence of bleeding and other complications. In this study a 0.6-mm (23 gauge) thin needle was used for splenic puncture and CT was used as a detector instead of a film-screen system. With this technique CT during percutaneous transsplenic portography may be performed on an outpatient basis.