Radiology of liver circulation
著者
書誌事項
Radiology of liver circulation
（Series in radiology, 11）
Nijhoff , Distributors for the U.S. and Canada, Kluwer Academic Publishers, 1985
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注記
Bibliography: p. [169]-174
内容説明・目次
内容説明
The liver blood flow disorders are usually described under the term 'portal hypertension', which is a well known syndrome since it has been widely studied for years from a clinical, radiological and therapeutic point of view. In fact, portal hypertension is only the result of an obstacle to the portal flow, the clinical manifestations of which often occur at a late stage of the disease: bleeding esophageal varices, splenomegaly, ascites. In addition, it is well known that there is not always a precise relationship between the degree of the obstruction, i.e. the decrease of the portal inflow and the level of the portal hypertension. A severe obstruction to the portal flow may therefore sometimes remain clinically inconspicuous for a long time. For this reason improvement of our knowledge of portal hypertension mainly relies on angiographic investigations. Thus, splenoportography permits the discovery of prehepatic obstructions whereas hepa tic venography permitted the recognition of two different types of intrahepatic obstruction according to the pre-sinusoidal or post -sinusoidal site of the obstacle. More recently, arterial hepatic changes could be evidenced through arteriography. However, these angiographic investigations have not yet allowed for all the problems about portal hypertension to be clearly identified.
目次
1. Normal Hepatic Circulation — Anatomy and Physiology.- I. The hepatic lobule and its three vascular axes.- II. Intrahepatic arterio-portal communications.- III. Normal hepatic circulation.- 2. Angiographic Methods.- I. Direct portal venous opacification.- II. Hepatic venous study.- III. Arterioportography.- IV. Computed tomography.- 3. The Main Arteriographic Signs of Portal Hypertension and their Hemodynamical Significance.- I. The mesenterico-portal axis opacification.- II. The spleen pattern.- III. Hepatic arterial changes.- 4. Presinusoidal Obstructions.- I. Proper angiographic signs.- II. The main causes of prehepatic obstructions.- III. Intrahepatic presinusoidal obstructions.- 5. Diffuse Post-Sinusoidal Obstructions.- I. Proper arteriographic signs.- II. Evaluation of the intensity of the obstruction.- III. Etiological diagnosis.- 6. Are There Portal Hypertensions Without Obstruction?.- I. Portal hypertension of splenic origin.- II. Portal hypertension and arteriovenous fistula.- 7. Contribution of Arterioportography to the Treatment of Portal Hypertension.- I. Checking of surgical porto-caval anastomosis by arterioportography.- II. Treatment of portal hypertension according to hemodynamical changes.- III. Interventional radiology and portal hypertension.- 8. Segmental Intrahepatic Obstructions without Portal Hypertension.- I. Segmental reversal of the intrahepatic portal flow: angiographic pattern.- II. Differential diagnosis of segmental reversal of intrahepatic portal flow: arterio-portal fistulae.- III. Etiological diagnosis.- IV. Conclusions.- General conclusions.- References.
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