2007 Volume 27 Issue 4 Pages 579-585
Diagnosis based on portal hemodynamics is essential for the clinical treatment of esophago-gastric varices ; multidetector computed tomography (MDCT) is used at our institution for this purpose. Two analytic methods are used in conjunction with MDCT : volume rendering (VR) and partial MIP. At present, the partial MIP method is more useful than the VR method, as partial MIP images clearly show the feeding and collateral veins in minute detail. Improvements in the analyzing power of MDCT have permitted the visualization of feeding veins as well as faint images of collateral veins associated with the varices. These images can be seen with a high degree of probability on MDCT images obtained using endoscopic varicerography during injection sclerotherapy. Diagnosis of the portal hemodynamics using MDCT prior to clinical treatment is likely to be an effective clinical option. However, numerous images are needed for the diagnosis of portal hemodynamics using partial MIP, and a detailed map of the portal hemodynamics is required to understand this diagnosis. Our objective is to use VR to overcome these diagnostic problems, since the use of a single image, which can be constructed within minutes, should permit the portal hemodynamics to be visualized.