CLINICAL EVALUATION OF HEPATIC VEIN CATHETERIZATION:Differential Diagnosis of Liver Cirrhosis from other Liver Diseases based on Venograms

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Hepatic vein catheterization was performed in 70 patients with liver diseases, and the radiographic findings of hepatic vein branches and sinusoidal fillings were classified into I-IV and a-c groups, respectively, in the order of seventies of changes. The usefulness of this procedure was assessed by comparing the venograms with other tests and measurements.1) Of the 41 patients with liver cirrhosis, 73.2% belonged to Grade IIIor IV. In contrast, 79.3% of the patients with other liver diseases showed changes of Grade II or a milder degree.2) When compared with the laparoscopic findings, 86.4% of the patients with 'a' group findings had a smooth liver surface and all of the 'c' group had nodules of 3mm or larger.3) These of radiographic changes of hepatic veins and sinusoidal fillings were well reflected in the grade of esophagial varices.It was concluded that if 2 or more of the following three changes were present, i.e. changes of III-b or severer in the Venogram, 150mmH2O or higher in the corrected WHVP, and 45% or less in the ICG extraction rate, a diagnosis of liver cirrhosis may be made with a 80% probability. In the mean time, if none of these changes were present, cirrhosis may be excluded with a similar probability.
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