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Comparison of Transplenic Multidetector CT Portography to Multidetector CT-Angiography in Normal Dogs

Rita L. Echandi F.M., William T. Daniel, Janet L. Paquette, Gregory B. Daniel,

Veterinary Radiology & Ultrasound, 2007. 48(1): p.38-44.

We evaluated transplenic injection of iodinated contrast medium for computed tomography (CT) assessment of the portal vasculature. Specific aims were to: (1) establish a protocol for transplenic transplenic CT portography using a 40-row multidetector scanner; (2) compare transplenic CT portography to dual-phase CT angiography in terms of image quality, opacification of the portal system, and contrast enhancement of the portal vasculature and liver; (3) compare personnel exposure during transplenic CT portography and transplenic portal scintigraphy. Seven juvenile dogs underwent transplenic portal scintigraphy, CT angiography, and transplenic CT portography. Transplenic portal scintigraphy and CT angiography were performed using previously established protocols. For transplenic CT portography, a 20- or 22 gauge needle attached to an extension set was placed into the splenic parenchyma using CT guidance. Iodinated contrast medium (175†mg I/ml) was administered, and CT acquisition was started at the time of the injection. Transplenic CT portography was simple, rapid and provided more intense enhancement of the splenic and portal veins, with a lower contrast medium dose (median dose: 525†mg I for transplenic CT portography, 7700†mg I for CT angiography), but caused inconsistent intrahepatic portal branches and parenchymal opacification due to streamlining and streak artifacts. Despite significantly lower attenuation values in the portal vein, CT angiography provided sufficient enhancement for vessel identification and more consistent parenchymal hepatic enhancement. Personnel radiation exposure rate was higher during transplenic CT portography (0.0725†mSv/min) compared with transplenic portal scintigraphy (0.000125†mSv/min). As transplenic CT portography requires an average injection time of 1†min per study; over 6500 studies must be performed before reaching the maximum permissible whole body dose of 0.5†Sv.