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Title: A new method for the measurement of intrahepatic shunts

Abstract

After transhepatic portal pressure determination, 96 patients were assessed for the presence of intrahepatic shunts by injection of microspheres (25 +/- 5 micron diameter) into the portal vein using RISA-131I as an indicator of dilution. Multiple portal vein injections in each patient allowed blood sampling from the hepatic vein (site 1) and from two inferior vena cava sampling sites (site 2, at the junction of the hepatic vein orifice with the inferior vena cava, and site 3, 2 to 3 cm closer to or within the right atrium). Intrahepatic shunting was calculated from each site: hepatic vein in 57 patients and inferior vena cava, site 2 in 43 patients and site 3 in 77 patients. At least one valid IHS calculation was available in 92 of the patients. Intrahepatic shunting calculated from sequential portal vein injections with sampling from the hepatic vein was highly correlated (r . 0.98, p less than 0.0001, slope . 1.0), with a mean difference of 1.9% +/- 1.9%. There was no significant difference by t test comparison of the mean IHS calculated from sites 1, 2, and 3. Occasional marked discrepancies were noted between IHS calculated from site 1 or site 2 compared with sitemore » 3, and the site 3 calculation was always greater. A shunt index in all patients included shunts calculated from the hepatic vein in 57 patients plus shunt calculation from the inferior vena cava in the remaining patients (site 2 in 26 patients and site 3 in nine). The 82 patients with portal hypertension or chronic liver disease had a higher portal pressure, 13.8 +/- 4.6 mm Hg, and a significantly greater shunt index, 13.7% +/- 24.5% compared with controls. The frequency distribution of IHS in patients with chronic liver disease demonstrated less than 2% IHS in 49% of patients and less than 5% IHS in 63%. The validity of our methods and the implications of the infrequent demonstration of a large IHS are discussed.« less

Authors:
; ; ;
Publication Date:
Research Org.:
University of California Irvine Medical Center, Orange
OSTI Identifier:
6915428
Resource Type:
Journal Article
Journal Name:
J. Lab. Clin. Med.; (United States)
Additional Journal Information:
Journal Volume: 103:3
Country of Publication:
United States
Language:
English
Subject:
59 BASIC BIOLOGICAL SCIENCES; LIVER; BLOOD FLOW; RADIOISOTOPE SCANNING; BLOOD PRESSURE; BLOOD VESSELS; IODINE 131; MICROSPHERES; PATIENTS; PRESSURE MEASUREMENT; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIGESTIVE SYSTEM; GLANDS; INTERMEDIATE MASS NUCLEI; IODINE ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPES; 551001* - Physiological Systems- Tracer Techniques

Citation Formats

Hoefs, J C, Reynolds, T B, Pare, P, and Sakimura, I. A new method for the measurement of intrahepatic shunts. United States: N. p., 1984. Web.
Hoefs, J C, Reynolds, T B, Pare, P, & Sakimura, I. A new method for the measurement of intrahepatic shunts. United States.
Hoefs, J C, Reynolds, T B, Pare, P, and Sakimura, I. 1984. "A new method for the measurement of intrahepatic shunts". United States.
@article{osti_6915428,
title = {A new method for the measurement of intrahepatic shunts},
author = {Hoefs, J C and Reynolds, T B and Pare, P and Sakimura, I},
abstractNote = {After transhepatic portal pressure determination, 96 patients were assessed for the presence of intrahepatic shunts by injection of microspheres (25 +/- 5 micron diameter) into the portal vein using RISA-131I as an indicator of dilution. Multiple portal vein injections in each patient allowed blood sampling from the hepatic vein (site 1) and from two inferior vena cava sampling sites (site 2, at the junction of the hepatic vein orifice with the inferior vena cava, and site 3, 2 to 3 cm closer to or within the right atrium). Intrahepatic shunting was calculated from each site: hepatic vein in 57 patients and inferior vena cava, site 2 in 43 patients and site 3 in 77 patients. At least one valid IHS calculation was available in 92 of the patients. Intrahepatic shunting calculated from sequential portal vein injections with sampling from the hepatic vein was highly correlated (r . 0.98, p less than 0.0001, slope . 1.0), with a mean difference of 1.9% +/- 1.9%. There was no significant difference by t test comparison of the mean IHS calculated from sites 1, 2, and 3. Occasional marked discrepancies were noted between IHS calculated from site 1 or site 2 compared with site 3, and the site 3 calculation was always greater. A shunt index in all patients included shunts calculated from the hepatic vein in 57 patients plus shunt calculation from the inferior vena cava in the remaining patients (site 2 in 26 patients and site 3 in nine). The 82 patients with portal hypertension or chronic liver disease had a higher portal pressure, 13.8 +/- 4.6 mm Hg, and a significantly greater shunt index, 13.7% +/- 24.5% compared with controls. The frequency distribution of IHS in patients with chronic liver disease demonstrated less than 2% IHS in 49% of patients and less than 5% IHS in 63%. The validity of our methods and the implications of the infrequent demonstration of a large IHS are discussed.},
doi = {},
url = {https://www.osti.gov/biblio/6915428}, journal = {J. Lab. Clin. Med.; (United States)},
number = ,
volume = 103:3,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 1984},
month = {Thu Mar 01 00:00:00 EST 1984}
}