Combined CT arterial portography and CT hepatic angiography for evaluation of the hepatic resection candidate. Work in progress

To determine whether the addition of computed tomographic (CT) angiography to CT arterial portography would improve lesion detection and heighten confidence in interpreting perfusion abnormalities.The two examinations were performed sequentially in 10 candidates for surgical resection of hepatic tumors. Arterial vascular access was obtained with bilateral punctures of the common femoral artery and selective placement of angiographic catheters in the hepatic artery and superior mesenteric artery (SMA). CT scans were obtained first during injection of contrast material into the SMA, followed by repeated imaging of the liver during injection of contrast material into the hepatic artery.The procedure demonstrated, among other results, three additional lesions in two patients, a possibly nontumorous abnormality as tumorous in one, and a suspected tumorous abnormality as nontumorous in one. Suspected nontumorous abnormalities in four patients were confirmed at CT angiography.These preliminary data support a trial of this technique in a larger population.