Diagnosis of Cirrhotic Portal Hypertension and Compensatory Circulation Using Transsplenic Portal Scintigraphy with 99mTc-Phytate

UNLABELLED: Our objective was to investigate the diagnostic value and clinical significance of transsplenic portal scintigraphy in cirrhotic portal hypertension and compensatory circulation. METHODS: Transsplenic portal scintigraphy, ultrasound, and gastroscopy were performed on 50 patients with cirrhotic portal hypertension and on 10 controls. According to the Child-Pugh classification, 15 patients with cirrhosis were Child A, 19 were Child B, and 16 were Child C. RESULTS: In the control group, the splenoportal vein was shaped like the letter S, and the portosystemic shunt index was 0.19 +/- 0.07. Portal hypertension portosystemic shunts were of 3 types: intrahepatic (13 patients; index, 0.52 +/- 0.19), compensatory (31 patients; index, 0.64 +/- 0.28); and completely extrahepatic (6 patients; index, 0.91 +/- 0.03). Collateral vessels were uphill, downhill, or complex. The portosystemic shunt index increased as cirrhosis and esophageal varices increased. There was statistical significance among groups (P < 0.05 or < 0.01). CONCLUSION: Transsplenic portal scintigraphy was sensitive for detecting the number and location of shunts and will allow for improved surgical planning.