CT DURING ARTERIAL PORTOGRAPHY - COMPARISON OF INJECTION INTO THE SPLENIC VERSUS SUPERIOR MESENTERIC-ARTERY

PURPOSE: To determine whether the diagnostic quality of computed tomog raphy (CT) during arterial portography (CTAP) performed via the spleni c artery (SA) is better than that performed via the superior mesenteri c artery (SMA). MATERIALS AND METHODS: The authors evaluated CTAP imag es obtained in 98 patients from 1991 to 1994; 47 examinations were per formed via the SA and 51 were performed via the SMA. Images were revie wed, by consensus, by three radiologists blinded to catheter location. Hepatic enhancement was quantitatively assessed in 53 patients (31 in the SA group, 22 in the SMA group). RESULTS: The numbers of low-atten uation non-tumor-related perfusion defects (19 in the SA group, 17 in the SMA group), high-attenuation non-tumor-related perfusion defects ( six in the SA group, six in the SMA group), diffuse mottled perfusion abnormalities (six in the SA group, five in the SMA group), and portal venous flow defects (20 in the SA group, 20 in the SMA group) were si milar in both groups (P > .05). Peak hepatic enhancement was similar i n both groups (SMA group = 111 HU; SA group = 112 HU) (P > .05). CONCL USION: There is no difference in quality between CTAP performed via th e SA versus CTAP performed via the SMA.