肝循環の臨床的研究

肝炎, 肝硬変の逆行性門脈造影像を中心に

抄録

Retrograde portography was performed to study the angiographic patterns of various liver diseases such as cirrhosis, tumor, Banti's syndrome and hepatitis using hepatic vein catheterization in 42 patients.
Cournand catheter was advanced into the hepatic vein until wedged. After taking wedged hepatic vein pressure, the tip of the catheter was withdrawn to about 10cm under diaphragma. Hepatic blood flow was measured by ICG clearance method. Contrast substance 80% sodium salt of 5-acetoamide-2, 4, 6, -triiode-N-methyl-isophthalamic acid was injected as rapid as possible when the tip was wedged again to take X-ray images of portal branches.
Circulatory systems described by retrograde portography of hepatic diseases were discussed considering these findings alongwith liver biopsy, functiontests and serum immunoglobulins.
Conclusion:
1) Venographic changes of sinusoids and portal branches were observed not only in liver cirrhosis but in some cases of chronic hepatitis.
2) In some cases of persisting hepatitis, the changes of visualized sinusoids were observed.
3) In diffuse liver diseases, the venographic findings of sinusoids and portal branches.
4) In the tumor, by an appropriate hepatic vein it was possible to diagnose the localization, size and shape.
5) In Banti's syndrome, venographic changes were more remarkable in intrahepatic portal branches rather than in hepatic vein branches.
6) There was no correlation betweenangiographic changes and S-GOT activity, T.T.T. and serum immunoglobulins.
7) The greater angiographic changes occured, the higher wedged hepatic vein pressure and also the less hepatic blood flow were observed.