Effect of temporary occlusion of the hepatic vein on dual blood in the liver: evaluation with spiral CT.

Murata, Satoru; Itai, Yuji; Asato, Masaya; Kobayashi, H; Nakajima, Kyoko; Eguchi, Naoto; Saida, Yasuhiko; Kuramoto, Kei; Tohno, E

doi:10.1148/radiology.197.2.7480676

Cited by 101 publications

(69 citation statements)

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“…Thermal ablation induces a marked increase in arterial perfusion in the surrounding liver within a few minutes after the start of treatment. The heated area of necrosis can cause hepatic segmental venous occlusion, and in this condition, the portal veins become draining veins and the occluded region is supplied with arterial blood alone (43). This phenomenon causes hyperattenuation in the occluded area at CT since arterial flow itself increases and the contrast medium is less diluted there.…”

Section: Discussionmentioning

confidence: 99%

Laser Thermal Ablation in the Treatment of Small Hepatocellular Carcinoma: Results in 74 Patients

Pacella¹,

Bizzarri²,

Magnolfi³

et al. 2001

Radiology

148

100

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PURPOSE: To evaluate the safety, local effectiveness, and long-term results of laser\ud thermal ablation (LTA) in the treatment of small hepatocellular carcinoma (HCC).\ud MATERIALS AND METHODS: Ninety-two biopsies proved small HCCs (range,\ud 0.8–4.0 cm) in 74 patients who were treated percutaneously with LTA in an\ud outpatient clinic. A laser at a power of 5.0Wwas coupled with one to four fibers that\ud were advanced through 21-gauge needle(s) for 6–12 minutes. All lesions were\ud evaluated with computed tomography (CT) for changes in size and vascular pattern,\ud recurrence rates, and cumulative survival rates. Patients were examined for complications.\ud RESULTS: No major complications occurred in 117 LTA sessions, with an average of\ud 1.3 sessions per tumor. At 3 months, CT scans showed a nonenhancing area\ud (complete necrosis) in 89 (97%) of 92 lesions. During follow-up (range, 6–66\ud months; mean, 25.3 months), 84 tumors (91%) decreased in size. The local recurrence\ud rates (range, 1–5 years) ranged from 1.6% to 6.0%. Recurrence rates (range,\ud 12–60 months) in other liver segments ranged from 24% to 73%. Cancer-free\ud survival rates (range, 1–4 years) ranged from 73% to 24%. Overall survival rates\ud were 99%, 68%, and 15% at 1, 3, and 5 years, respectively. Twenty-one patients\ud (28%) died.\ud CONCLUSION: LTA is a safe and effective treatment for small HCC

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Section: Discussionmentioning

confidence: 99%

Laser Thermal Ablation in the Treatment of Small Hepatocellular Carcinoma: Results in 74 Patients

Pacella¹,

Bizzarri²,

Magnolfi³

et al. 2001

Radiology

148

100

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“…On the other hand, it is well known that when hepatic venous flow is obstructed, the portal flow in the obstructed segment is markedly reduced or even reversed resulting in the same hemodynamic conditions as in intrahepatic portal venous occlusion [11,12]. Indeed, the intrahepatic venous flow obstruction also induces marked atrophy of the obstructed liver parenchyma as commonly observed in Budd-Chiari syndrome [27].…”

Section: Discussionmentioning

confidence: 97%

“…It is widely recognized that a decreased or reversed flow of the portal blood supply can be seen when the hepatic venous flow is obstructed [11,12]. As a result, parenchymal changes similar to those evoked by portal venous flow blockage can be expected, resulting in marked fibrosis in the area with hepatic venous flow disturbance.…”

Section: Introductionmentioning

confidence: 99%

Confluent hepatic fibrosis in liver cirrhosis: possible relation with middle hepatic venous drainage

et al. 2013

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“…Although portal vein Doppler profiles are not generally considered in diagnosing hepatic venous obstruction, portal flow has been shown to decrease, or even reverse in cases of acute and severe outflow obstruction such as Budd-Chiari syndrome and hepatic veno-occlusive disease. [24][25][26][27] The usual cause of hepatic vein obstruction after liver transplantation is anastomotic stenosis. Its incidence has been reported to be 4% to 6% of living donor liver transplantations using right-lobe grafts.…”

Section: Discussionmentioning

confidence: 99%

Hepatofugal Portal Venous Flow on Doppler Sonography After Liver Transplantation

Jeong

Kim

Lee

et al. 2012

Journal of Ultrasound in Medicine

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Objectives The purpose of this study was to categorize hepatofugal portal venous flow on Doppler sonography after liver transplantation and to investigate its clinical importance and presumed causes based on radiologic and pathologic findings. Methods This retrospective study was approved by our Institutional Review Board, and the requirement for informed consent was waived. Examination of our database over 4 years revealed 30 patients in whom Doppler sonography showed hepatofugal portal venous flow during follow‐up periods. We investigated its occurrence and clinical features, including radiologic and pathologic findings, and classified the possible causes into 5 types: A, systemic problems; B, gross vascular abnormalities correctable by intervention; C, specific cardiac problems; D, microscopic abnormalities of the graft; and E, miscellaneous. We classified the patterns of hepatofugal portal venous flow into continuous hepatofugal or hepatofugal‐dominant to‐and‐fro flow and hepatopetal‐dominant to‐and‐fro flow, and we investigated the relationship of the presumed causes and flow patterns with the clinical course. Results The incidence of hepatofugal portal venous flow was 2.38%. The overall mortality rate was 26.67% (95% confidence interval, 11.1%–42.9%): all patients (n = 5) in group A, 1 in group C, and 2 in group D, died. Possible cause type B and a mainly hepatopetal flow pattern were good prognostic factors (P = .031 and .018, respectively). Conclusions Hepatofugal portal venous flow reflects diverse pathologic conditions after liver transplantation, and its clinical importance also differs depending on the cause.

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Effect of temporary occlusion of the hepatic vein on dual blood in the liver: evaluation with spiral CT.

Abstract: After hepatic venous occlusion, the portal veins become draining veins and the occluded area is supplied with arterial blood alone.

Cited by 101 publications

References 0 publications

Laser Thermal Ablation in the Treatment of Small Hepatocellular Carcinoma: Results in 74 Patients

Laser Thermal Ablation in the Treatment of Small Hepatocellular Carcinoma: Results in 74 Patients

Confluent hepatic fibrosis in liver cirrhosis: possible relation with middle hepatic venous drainage

Hepatofugal Portal Venous Flow on Doppler Sonography After Liver Transplantation

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