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CO2 digital subtraction splenoportography with the "skinny" needle: experimental study in a swine model
1Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0030, USA. kyungcho@umich.edu
Purpose:
To evaluate the safety and the effectiveness of CO2 splenoportography with the "skinny" needle.
Methods:
A flexible, 22 gauge needle ("skinny" needle) was introduced into the exteriorized spleens of five pigs. After checking the intrasplenic positioning with CO2 injection, increasing doses of CO2 (10-60 cm3) were injected using a dedicated CO2 injector with digital imaging. The puncture sites were observed during and after CO2 injections, and after removal of the needle. The spleens were then removed for gross and microscopic examination.
Results:
In all animals digital subtraction CO2 splenoportograms showed the splenic, extra- and intrahepatic portal veins, and the most distal portion of the superior mesenteric vein. No CO2 extravasation occurred in the spleen. There was no significant bleeding from the puncture site after removal of the needle. Gross and microscopic examination revealed no evidence of splenic rupture or intrasplenic hematoma.
Conclusion:
CO2 splenoportography with the "skinny" needle is a safe and simple method of visualizing the portal vein and its branches. Careful appraisals of the clinical usefulness of the method will be needed in various clinical settings.
