[Assessment of portal blood flow by isotope splenoportography. Methodology and 1st results in cirrhosis].

The authors report a new non-invasive method of portal blood flow (PBF) measurement, after injection of a radiotracer into the spleen. PBF was equal to the product of the radiotracer bolus velocity and the cross-section area of the portal vein as measured by ultrasonography. In 16 patients with cirrhosis, the velocity of the portal blood flow (V) and PBF were determined in 11 cases. In the remaining 5 patients, failures were explained by either a total extrahepatic shunt (3 cases) or difficulties of scanning view analysis (2 cases). Mean values of V and PBF were 8.8 +/- 2.5 cm/s and 579 +/- 193 ml/min respectively, which represent a reduction of 50 p. 100 compared to estimated normal values. This method was also useful to appreciate the fraction of PBF which is supposed to reach the liver cells called the "actual portal blood flow" (APBF). APBF was equal to PBF minus the fraction of blood flowing through intrahepatic shunts and/or the recanalized umbilical vein. In the 16 cases, mean values were 528 +/- 184 ml/min for APBF, 11.9 +/- 1.7 cm for the portal vein diameter, and 53 +/- 34 p. 100 for spleen blood flow fraction going through porto-systemic collateral veins. Significant intrahepatic shunt was observed in one patient only out of 13 without total extrahepatic shunt, i. e., in 8 p. 100 of the cases. The impossibility of measuring PBF when a total extrahepatic shunt is present is a drawback in the use of this new technique.(ABSTRACT TRUNCATED AT 250 WORDS)