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CO2 wedged hepatic venography in the evaluation of portal hypertension

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dc.creator Debernardi-Venon, Wilma
dc.creator Bandi, J. C.
dc.creator García Pagán, Juan Carlos
dc.creator Moitinho, E.
dc.creator Andreu, V.
dc.creator Real, M.
dc.creator Escorsell i Mañosa, M. Àngels
dc.creator Montanyá, X.
dc.creator Bosch i Genover, Jaume
dc.date 2011-07-07T12:30:26Z
dc.date 2011-07-07T12:30:26Z
dc.date 2000
dc.date.accessioned 2024-12-16T10:27:14Z
dc.date.available 2024-12-16T10:27:14Z
dc.identifier 0017-5749
dc.identifier http://hdl.handle.net/2445/18653
dc.identifier 159661
dc.identifier 10807900
dc.identifier.uri http://fima-docencia.ub.edu:8080/xmlui/handle/123456789/22126
dc.description BACKGROUND/AIMS/METHODS During hepatic vein catheterisation, in addition to measurement of hepatic venous pressure gradient (HVPG), iodine wedged retrograde portography can be easily obtained. However, it rarely allows correct visualisation of the portal vein. Recently, CO2 has been suggested to allow better angiographic demonstration of the portal vein than iodine. In this study we investigated the efficacy of CO2 compared with iodinated contrast medium for portal vein imaging and its role in the evaluation of portal hypertension in a series of 100 patients undergoing hepatic vein catheterisation, 71 of whom had liver cirrhosis. RESULTS In the overall series, CO2 venography was markedly superior to iodine, allowing correct visualisation of the different segments of the portal venous system. In addition, CO2, but not iodine, visualised portal-systemic collaterals in 34 patients. In cirrhosis, non-visualisation of the portal vein on CO2 venography occurred in 11 cases; four had portal vein thrombosis and five had communications between different hepatic veins. Among non-cirrhotics, lack of portal vein visualisation had a 90% sensitivity, 88% specificity, 94% negative predictive value, and 83% positive predictive value in the diagnosis of pre-sinusoidal portal hypertension. CONCLUSIONS Visualisation of the venous portal system by CO2 venography is markedly superior to iodine. The use of CO2 wedged portography is a useful and safe complementary procedure during hepatic vein catheterisation which may help to detect portal thrombosis. Also, lack of demonstration of the portal vein in non-cirrhotic patients strongly suggests the presence of pre-sinusoidal portal hypertension.
dc.format 5 p.
dc.format application/pdf
dc.language eng
dc.publisher BMJ Group
dc.relation Reproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.46.6.856
dc.relation Gut, 2000, vol. 46, núm 6, p. 856-860
dc.relation http://dx.doi.org/10.1136/gut.46.6.856
dc.rights (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2000
dc.rights info:eu-repo/semantics/openAccess
dc.source Articles publicats en revistes (Medicina)
dc.subject Hipertensió portal
dc.subject Hemodinàmica
dc.subject Diagnòstic per la imatge
dc.subject Cirrosi hepàtica
dc.subject Portal hypertension
dc.subject Hemodynamics
dc.subject Diagnostic imaging
dc.subject Hepatic cirrhosis
dc.title CO2 wedged hepatic venography in the evaluation of portal hypertension
dc.type info:eu-repo/semantics/article
dc.type info:eu-repo/semantics/publishedVersion


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