Kobayashi Satoshi, Ng Chaan S, Kazama Toshiki, Madoff David C, Faria Silvana C, Vauthey Jean N, Charnsangavej Chusilp
Department of Diagnostic Radiology, Unit 057, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA.
J Comput Assist Tomogr. 2004 Nov-Dec;28(6):804-10. doi: 10.1097/00004728-200411000-00013.
To evaluate hemodynamic and morphologic effects in the liver after portal vein embolization (PVE).
Hepatic computed tomography scans of 7 patients who had undergone preoperative PVE were retrospectively reviewed. Pre- and post-PVE computed tomography densities were evaluated for the unenhanced, late arterial, and portal venous phases in peripheral and central hepatic regions and in the 3 main hepatic veins. Relative changes in areas in these regions were assessed in 5 evaluable patients with serial post-PVE scans.
During the late arterial phase, enhancement was significantly higher after PVE than it was before PVE in the peripheral hepatic regions, and it was higher in the peripheral regions than in the central regions. Enhancement was also significantly higher in the right main hepatic vein than in the middle and left hepatic veins during the late arterial phase. The ratio of areas of the peripheral/central regions decreased significantly after PVE.
Zonal enhancement in the late arterial phase changed after PVE and seemed to be associated with differential parenchymal atrophy. We speculate that the hepatic arterial supply increases peripherally and that peribiliary/periportal plexuses maintain the portal supply centrally.
评估门静脉栓塞术（PVE）后肝脏的血流动力学和形态学变化。
回顾性分析7例术前接受PVE患者的肝脏计算机断层扫描（CT）图像。评估PVE前后外周和中央肝区以及3条主要肝静脉在平扫、动脉晚期和门静脉期的CT密度。对5例可评估患者进行PVE后系列扫描，评估这些区域面积的相对变化。
在动脉晚期，PVE后外周肝区的强化明显高于PVE前，且外周区域高于中央区域。在动脉晚期，右主肝静脉的强化也明显高于中肝静脉和左肝静脉。PVE后外周/中央区域面积比显著降低。
PVE后动脉晚期的区域强化发生改变，似乎与实质的差异性萎缩有关。我们推测肝动脉供应在外周增加，而胆小管/门静脉周围丛在中央维持门静脉供应。
