Ultrafine needle CO2 splenoportography: a comparative investigation with transarterial portography and MR portography.

Abstract Purpose To evaluate the safety and quality of CO 2 splenoportography (CO 2 -SP) by comparison to 3-dimensional dynamic contrast-enhanced magnetic resonance portography (3D-DCE-MRP) and transarterial portography (TAP). Materials and methods CO 2 -SP, 3D-DCE-MRP and TAP were performed within 3 days in 35 patients. CO 2 -SP was conducted with a 26 G needle by puncture of spleen under fluoroscopy and/or ultrasound guidance. A fifty mm 3 of CO 2 was manually injected within 3 s. The safety and the side effects of CO 2 -SP were assessed with a scoring system based on both the subjective feeling of patients questioned and the objective appearances of vital signs, electrocardiogram (ECG) and saturation of percutaneous blood oxygen (SpO 2 ). The quality of the imaging was compared among the three groups using different methods by a scoring criterion based on visualization of the portal branches. Results Transient mild discomfortable reaction was present in 18 patients (51.4%). The scores measured for quality of portal vein branch visualization in the groups with CO 2 -SP, 3D-DCE-MRP and TAP were 226, 196 and 167, respectively ( P Conclusion Ultrafine needle CO 2 -SP is safe and minimally invasive. The quality of CO 2 -SP is better than that with 3D-DCE-MRP and TAP in terms of the visualizing portal vein branches.