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目的回顾性分析应用二氧化碳气体（ＣＯ２）和含碘液性造影剂（ＩＣ）行肝静脉楔入法造影，探讨两种不同方法显示门静脉的能力。方法在４３例行经颈静脉肝内门体静脉分流术（ＴＩＰＳ）治疗的患者中，门静脉穿刺前行肝静脉楔入法造影，２３例应用ＣＯ２，２０例用ＩＣ。４２例门静脉穿刺后应用ＩＣ行直接法门静脉造影。分析应用两种造影剂行肝静脉楔入法造影显示门静脉的结果，并同直接法造影加以比较。结果在肝静脉楔入法造影中，应用ＣＯ２门静脉显示优良者为９１％（２１／２３），应用ＩＣ，则仅为１０％（２／２０）。ＣＯ２楔入法同直接法相比，结果基本一致以上者为８７％（２０／２３），而ＩＣ为１０％（２／２０）。３例ＴＩＰＳ失败者，２例行ＣＯ２楔入法造影显示了门静脉结构异常，１例未行ＣＯ２楔入法造影。结论应用ＣＯ２行肝静脉楔入法造影，可更容易和准确地显示门静脉的解剖结构。
Objective To retrospectively analyze the hepatic venous wedge angiography using carbon dioxide gas (CO2) and iodine-containing contrast medium (IC), and to explore the ability of two different methods to display the portal vein. Methods In 43 patients undergoing transjugular intrahepatic portosystemic venous shunt (TIPS), hepatic venous wedge angiography was performed before portal vein puncture. Twenty-three patients underwent CO2 and 20 patients received IC. 42 cases of portal vein puncture using IC line direct method of portal vein angiography. Analysis of the application of two contrast agents hepatic venous wedge angiography showed portal vein results, and compared with direct contrast imaging. Results In hepatic venous wedge radiography, CO2 portal vein was shown to be 91% (21/23) in excellent, and 10% (2/20) in IC. CO2 wedge method compared with the direct method, the results were basically the same as 87% (20/23), while the IC was 10% (2/20). Three cases of TIPS failure, 2 cases of CO2 wedge angiography showed portal vein anomalies, 1 case without CO2 wedge radiography. Conclusion The hepatic venous wedge radiography with CO2 can show the anatomy of the portal vein more easily and accurately.