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. 2012 May;85(1013):587–595. doi: 10.1259/bjr/25522379

Figure 1.

Figure 1

A 76-year-old female with hepatitis C-related cirrhosis (case 6). (a) Portogram obtained by percutaneous transhepatic portography (PTP). This portogram had positive findings of some winding or distortion in the large intrahepatic portal branches, peripheral vessels were more or less straight with minimal winding, peripheral vessels were divided at regular acute angles in most places, there was no crossing over or abrupt cut-off of the vessels, contrast medium reached the periphery without stopping short of the liver capsule or leaving an avascular area beneath the liver surface, and there were occasional small irregularities along the portal branches suggesting compression by regenerating nodules with no finding suggestive of idiopathic portal hypertension (IPH), according to the review results by Reviewer I. This patient was diagnosed as having cirrhosis by a score of –6 on the PTP image. (b) Multiplanar reconstruction image. Three plane images (upper left, horizontal image; lower left, coronal image; upper right, sagittal image) provided only fragmented information of vascular findings, which were hard to compare with angiographic images. The lower right image shows dendritically expanded intrahepatic portal vein appearances. This rendered stereoscopic image was rotated to correspond with the angiographic image and used as the contrast-enhanced three-dimensional (3D) ultrasound sonogram. (c) Portograms obtained by PTP and contrast-enhanced 3D ultrasound with Sonazoid® (GF Healthcare, Oslo, Norway). Corresponding portal veins between the PTP image (left side) and the 3D ultrasound image (right side) are indicated by the lines. Contrast-enhanced 3D ultrasound with Sonazoid had positive findings of some winding or distortion in the large intrahepatic portal branches, peripheral vessels were more or less straight with minimal winding, peripheral vessels were divided at regular acute angles in most places and there was no crossing over or abrupt cut-off of the vessels with no finding suggestive of IPH according to the review results by Reviewer IV. This patient was also diagnosed as having cirrhosis by a score of –4 on the 3D ultrasound image.