Purpose: To evaluate the safety and quality of CO2 splenoportography (CO2-SP) by comparison to 3-dimensional dynamic contrast-enhanced magnetic resonance portography (3D-DCE-MRP) and transarterial portography (TAP).
Materials and methods: CO2-SP, 3D-DCE-MRP and TAP were performed within 3 days in 35 patients. CO2-SP was conducted with a 26G needle by puncture of spleen under fluoroscopy and/or ultrasound guidance. A fifty mm3 of CO2 was manually injected within 3s. The safety and the side effects of CO2-SP were assessed with a scoring system based on both the subjective feeling of patients questioned and the objective appearances of vital signs, electrocardiogram (ECG) and saturation of percutaneous blood oxygen (SpO2). The quality of the imaging was compared among the three groups using different methods by a scoring criterion based on visualization of the portal branches.
Results: Transient mild discomfortable reaction was present in 18 patients (51.4%). The scores measured for quality of portal vein branch visualization in the groups with CO2-SP, 3D-DCE-MRP and TAP were 226, 196 and 167, respectively (P<0.001, the higher of the scores, the better of the quality). The visibility of collateral veins was not significantly different amongst the three imaging techniques.
Conclusion: Ultrafine needle CO2-SP is safe and minimally invasive. The quality of CO2-SP is better than that with 3D-DCE-MRP and TAP in terms of the visualizing portal vein branches.