Title: Abstract No. 317 EE: Evaluation of the Portal Venous System with Transarterial CT Portography: Indications, Technique, and Examples
Abstract: The portal venous system was traditionally evaluated with transarterial, transhepatic, or trans-splenic portography. Advantages of these techniques include high contrast resolution and ability to visualize flow dynamically. However, the two-dimensional nature of angiography limits characterization of complex portal venous anatomy. Cross-sectional and three-dimensional (3D) imaging of the portal venous system can be performed noninvasively with contrast-enhanced CT (CECT). Disadvantages of CECT include lower contrast resolution and limited information on hemodynamics. Transarterial CT portography (TACTP) combines the advantages of angiography and CECT. This exhibit describes the technique and indications for TACTP and provides pictorial examples of the unique strengths of this examination. The technique for TACTP will be described in detail and indications for the exam will be discussed. To illustrate the higher quality characterization of the portal venous system permitted by TACTP, cross-sectional and 3D reconstructed images from TACTP will be shown along with comparative images from angiographic portography and CECT. TACTP combines the strengths of traditional angiographic portography with the cross-sectional and 3D capabilities of CECT. It is technically straightforward to perform, with rare complications. This exam should be considered in cases where high-resolution characterization of complex splanchnic and portal venous anatomy is required.