Diagnosis of cirrhotic portal hypertension and compensatory circulation using transsplenic portal scintigraphy with 99mTc-phytate

Abstract

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. Copyright © 2010 by the Society of Nuclear Medicine, Inc.