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    Lower prevalence of non-tumoral perfusion defects in left hepatic lobe during CT arterial portography with splenic artery injection
    (Elsevier Sci Ireland Ltd, 2004) Kutlu, R; Akbulut, A; Sigirci, A; Alkan, A; Karaman, I; Baysal, T; Sarac, K
    Objective: To determine whether there is a difference in the prevalence of non-tumoral perfusion defects (NTPD) in left hepatic lobe during CT arterial portography (CTAP) through splenic (SA) and superior mesenteric artery (SMA) injection. Methods and patients: For the preoperative evaluation, 59 patients (20 females, 39 males) who either have colorectal carcinoma metastasis (n: 42) or hepatocellular carcinoma (n: 17) underwent CTAP examination. Patients were divided, into two groups (SA and SMA) according to the injection artery. The presence and type of NTPD in the left hepatic lobe were determined and compared. Results: There were significant differences in peripherally located wedge shaped, perihilar-periligamentous and pericholecystic NTPD, but no significant difference was found in lobar/segmental defects between the groups. Conclusions: Our study demonstrated lower prevalence of NTPD in the left hepatic lobe in CTAP's performed through SA injection and we think that this could be explained by the streamlining of portal blood flow. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
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    Quantitative Doppler evaluation of the splenoportal venous system in various stages of cirrhosis
    (John Wiley & Sons Inc, 2002) Kutlu, R; Karaman, I; Akbulut, A; Baysal, T; Sigirci, A; Alkan, A; Aladag, M
    Purpose. The purpose of our study was to evaluate the relationship between the splenoportal hemodynamics in patients with cirrhosis and the stage of the disease. Methods. Patients with cirrhosis were grouped according to modified Child-Pugh scoring into stages A, B, and C of cirrhosis. A control group of healthy volunteers was included. After gastroenterologic clinical and laboratory examinations, all participants underwent a splenoportal Doppler sonographic evaluation in which the vessels' diameter, area, and blood flow velocity were measured and blood flow rate and the congestion index in the splenoportal venous system were calculated. Results. Seventy-five patients with cirrhosis (25 women and 50 men) were enrolled; the control group consisted of 30 healthy volunteers (15 women and 15 men) with no liver disease. The mean age (+/- standard deviation) of the patients was 54.4 +/- 14.8 years (range, 13-80 years) and of the control subjects was 47.3 +/- 14.5 years (range, 18-72 years). No significant differences in vessel diameter, blood flow velocity, and blood flow rate were found in the main and left portal veins between the study group and the control group. In the right portal vein, we found decreases in the vessel diameter, blood flow velocity, and blood flow rate, and in the splenic vein, we found increases in vessel diameter and blood flow rate. The congestion index was increased in the main portal and splenic veins but was unchanged in the left portal vein. Conclusions. Although our data indicate that there is no difference in Doppler sonographic parameters of the main portal vein according to Child-Pugh scores, the hemodynamic differences between the left and right branches of the portal vein may be clinically useful in patients with cirrhosis. (C) 2002 Wiley Periodicals, Inc.