Comparison of visualization at pharmacological superior mesenteric arterioportography (P-SMA) and three-dimensional computed tomography during arterial portography (3D-CTAP)

In cases of malignant tumors that are likely to invade portal veins, such as hepatocellular carcinoma or cholangiocellular carcinoma, pharmacological superior mesenteric arterioportography (P-SMA) is an indispensable examination for determining clinical stage and the strategy of the treatment. However, this examination entails a great burden on patients physically and mentally. Computed tomography during arterial portography (CTAP) is also a useful examination for detecting liver tumors. In this study, we compared the degree of visualization of portal veins in images obtained by P-SHA with three-dimensional images produced from images obtained by CTAP (3D-CTAP). As the results, 3D-CTAP had consistently higher degree of contrast than that of images obtained by P-SMA and depicted the third-order blanches of portal veins. Therefore, 3D-CTAP enabled evaluation of the degree of invasion of the portal veins on the basis of the 'General Rules for the Clinical and Pathological Study of Primary Liver Cancer' by the Liver Cancer Study Group of Japan. It was concluded that P-SMA examination did not necessarily needed when 3D-CTAP could be produced. That led to somewhat reducing the burden on patient in invasive examinations. (author)