Skip to main content
SpringerLink
Log in

Radioisotopic splenoportography in patients with portal hypertension

  • Original Articles
  • Published:
The Japanese journal of surgery Aims and scope Submit manuscript

Abstract

Radio-isotopic splenoportography was performed by injecting99mTcO4 − into the spleens of 46 patients with portal hypertension and 14 patients with various disorders not having portal hypertension. No collateral circulation was demonstrated in the 14 patients without portal hypertension whereas some RI-images of portosystemic collaterals were found in 40 (87.0 per cent) of the 46 patients with portal hypertension. Collaterals were divided into an ascending group and a descending group, the appearance rate of ascending collaterals being 80.4 per cent and that of descending collaterals, 41.3 per cent. There were 3 image patterns in the ascending group, namely, an AZ-pattern in which the azygos vein was demonstrated; a SC-pattern in which the RI-bolus ascended along the esophagus to the neck and the subclavian vein; and an EG-pattern which showed stagnation of the RI-bolus in the esophagogastric region. There were 4 patterns in the descending group, namely; a pattern of gastro-renal caval shunt (GR-pattern); reverse flow patterns into the umbilical or paraumbilical veins (UV-pattern); into the superior mesenteric vein (SMV-pattern); and into the inferior mesenteric vein (IMV-pattern). The appearance of the EG-pattern was seen most frequently (74.4 per cent). The usefulness of this method for surveying the collateral circulation in portal hypertension, estimating the risk of esophageal variceal bleeding and evaluating its treatments, was suggested by the results of this study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abeati S, Campi L. Sur les possibilités de l’angiographie hépatique. Acta Radiol 1951; 35: 383–392.

    Google Scholar 

  2. Kuba J, Seidlova V. Evaluation of portal circulation by the scintillation camera. J Nucl Med 1972; 13: 689–692.

    PubMed  CAS  Google Scholar 

  3. Kashiwagi T, Kamada T, Abe H. Dynamic studies on the portal hemodynamics by scintiphotospleno-portography: the visualization of portal venous system using99mTc. Gastroenterology 1974; 67: 668–673.

    PubMed  CAS  Google Scholar 

  4. Newman HF, Cohen JB. Estimation of the portal circulation time in man. J Lab Clin Med 1949; 34: 674–676.

    PubMed  CAS  Google Scholar 

  5. Grunert RD, Oeff K, Schmidt H. Intravenous radio-portography. Screening procedure for patients with portal hypertension. Arch Surg 1965; 90: 237–239.

    PubMed  CAS  Google Scholar 

  6. Greenlaw RH, Schwartz SI. Evaluation of portal circulation by percutaneous splenic isotope injection. J Nucl Med 1961; 2: 85–93.

    PubMed  CAS  Google Scholar 

  7. Ueda H, Kitani K, Kameda H, Yamada H, Iio M. Detection of portal systemic shunts by hepato-pulmonary scanning using I131 MAA. Study and application of macroaggregated albumin (MAA) labelled with I131 (III). Jap Heart J 1965; 6: 115–127.

    Google Scholar 

  8. Hofer R, Ogris E, Pfeiffer G. Splenoportoscintigraphy to demonstrate portosystemic shunts. J Nucl Med 1968; 9: 624–629.

    PubMed  CAS  Google Scholar 

  9. Castell DO, Grace ND, Wennar MH, Chalmers TC, Moore EW. Evaluation of portal circulation in hepatic cirrhosis. A new method using xenon133. Gastroenterology 1969; 57: 533–541.

    PubMed  CAS  Google Scholar 

  10. Aoki H, Hasumi A, Ishida T. Indication of operation for esophagogastric varices and its limitation. Shokakigeka 1982; 5: 403–411.

    Google Scholar 

  11. Koyanagi N, Inokuchi K, Matsuura K. Increased blood flow in the stomach of cirrhotic patients as assessed by radionuclide angiography. Eur Surg Res 1985; 17: 341–346.

    PubMed  CAS  Google Scholar 

  12. Cales P, Braillon A, Jiron MI, Lebrec D. Superior portosystemic collateral circulation estimated by azygos blood flow in patients with cirrhosis. Lack of correlation with esophageal varices and gastrointestinal bleeding. Effect of propranolol. J Hepatol 1985; 1: 37–46.

    Article  PubMed  CAS  Google Scholar 

  13. Gillot C, Castel A, Walting P, Wanstok E, Varay A. Les anastomoses veineuses spléno-rénales et gastro-rénales spontanées. Étude par phlabographie cave occlusive. Arch Mal App Dig 1968; 57: 39–56.

    CAS  Google Scholar 

  14. Aseni P, Beati C, Brambilla G, Bertini M, Belli L. Does large spontaneous portal systemic shunt in cirrhosis protect from risk of gastroesophageal bleeding? J Clin Gastroenterol 1986; 8: 235–238.

    PubMed  CAS  Google Scholar 

  15. Wexler MJ, Maclean LD. Massive spontaneous portal-systemic shunting without varices. Arch Surg 1975; 110: 995–1003.

    PubMed  CAS  Google Scholar 

  16. Price JB, Vorhees AB, Blakemore AH. Spontaneous hemodynamically effective portasystemic shunts. 1963; 158: 189–194.

    Google Scholar 

  17. Gadrat J, Ribet A, Suduca P, Pascal JP. Anastomose spléno-rénale vraie spontanée au cours d’une cirrhose primitive avec hypertension portale. Arch Mal App Dig 1969; 58: 257–262.

    CAS  Google Scholar 

  18. Berchtold R. Über die kollateralen und die spontanen Anastomosen zwischen Pfortader und Hohlvenen beim Pfortaderhochdruck. Schweiz Med Wschr 1961; 91: 533–537.

    Google Scholar 

  19. Johns TNP, Blackwell BE. Collateral pathways in portal hypertension. Ann Surg 1962; 155: 838–845.

    Article  PubMed  CAS  Google Scholar 

  20. Ohnishi K, Sato S, Saito M, Terabayashi H, Nakayama T, Saito M, Chin N, Iida S, Nomura F, Okuda K Clinical and portal hemodynamic features in cirrhotic patients having a large spontaneous splenorenal and/or gastrorenal shunt. Am J Gastroenterol 1986; 81: 450–455.

    PubMed  CAS  Google Scholar 

  21. Takashi M, Igarashi M, Hino S, Takayasu K, Goto N, Musha H, Ohnishi K, Okuda K. Portal hemodynamics in chronic portal systemic encephalopathy. Angiographic study in seven cases. J Hepatol 1985; 1: 467–476.

    Article  PubMed  CAS  Google Scholar 

  22. Lafortune M, Constantin A, Breton G, Légaré AG, Lavoie P. The recanalized umbilical vein in portal hypertension: a myth. AJR 1985; 144: 549–553.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The First Department of Surgery, Asahikawa Medical College, Nishikagura 4-5-3, 078, Asahikawa, Japan

    Natsuki Samejima MD, Koichiro Ikeda, Yasuhiro Yokoyama & Satoru Hirata

Authors
  1. Natsuki Samejima MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koichiro Ikeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasuhiro Yokoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Satoru Hirata
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Samejima, N., Ikeda, K., Yokoyama, Y. et al. Radioisotopic splenoportography in patients with portal hypertension. The Japanese Journal of Surgery 19, 269–277 (1989). https://doi.org/10.1007/BF02471401

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02471401

Key Words

Search

Navigation