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Small Arterial-Portal Venous Shunts: A Cause of Pseudolesions at Hepatic Imaging

 Jeong-Sik Yu  ;  Ki Whang Kim  ;  Kyu Bo Sung  ;  Jong Tae Lee  ;  Hyung Sik Yoo 
 RADIOLOGY, Vol.203(3) : 737-742, 1997 
Journal Title
Issue Date
Angiography ; Arteries ; Arteriovenous Fistula/diagnostic imaging* ; Arteriovenous Fistula/surgery ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/surgery ; Contrast Media ; Follow-Up Studies ; Hemodynamics ; Hepatic Artery/diagnostic imaging ; Humans ; Intraoperative Care ; Iodized Oil ; Liver/blood supply* ; Liver Diseases/diagnostic imaging* ; Liver Diseases/surgery ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Portal Vein* ; Portography ; Prospective Studies ; Radiographic Image Enhancement ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography, Interventional
PURPOSE: To compare hepatic angiographic findings of small arterial-portal venous shunts with those of other imaging modalities, and to determine whether these shunts are related to hepatocellular carcinoma. MATERIALS AND METHODS: At hepatic angiography in 223 patients, small arterial-portal venous shunts not directly related to hepatocellular carcinoma and focal areas of parenchymal contrast material enhancement more than 1 cm in diameter were found in 28 patients. These 28 patients were prospectively evaluated with computed tomography (CT) during arterial portography (CTAP) (n = 12), CT after iodized oil administration (n = 23), intraoperative ultrasonography (n = 5), or follow-up hepatic angiography (n = 13). Magnetic resonance (MR) images (n = 10) and dynamic CT scans (n = 4) in these patients were retrospectively reviewed. RESULTS: Arterial-portal venous shunts noted at angiography manifested as perfusion defects at CTAP in 10 patients and as an area of arterial contrast enhancement at dynamic CT in three patients. No lesion was seen at MR imaging, and no persistent iodized oil uptake was seen at CT. There was no evidence of hepatocellular carcinoma tumor growth around the shunts at follow-up angiography, and no tumor was present at surgery. CONCLUSION: Understanding of the hemodynamic changes caused by these small shunts can aid in the interpretation of vascular imaging findings.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
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