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10.5832/m76-1-5-0

Liver parenchyma-Hepatic perfusion disorder / THAD

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Imaging general - typical

General morphology
  • Transient hyperdensity / hyperintensity at early-phase contrast-enhanced CT or MR imaging
  • Often wedge-shaped configuration
  • The cause of the perfusion disorder may be visible [1]http://dx.doi.org/10.1097/RCT.0b013e31818050bc[2]
    • eg portal vein thrombosis, extrinsic compression
  • Clues to the diagnosis include:
    • Peripheral location
    • Geographic or wedge shape
    • Nondisplaced internal vasculature
    • Isodense / isointense to liver on all unenhanced images
  • Usually focal; may be segmental / lobar [Fig 1]
  • Diffusely abnormal perfusion is seen in right heart disease and hepatic vein occlusion [Fig 2] [Fig 3] [Fig 4]
 
Specific features
  1. Focally decreased portal venous inflow
  2. Anatomical variations with "third hepatic inflow" [Fig 15] [Fig 16]
  3. Arterioportal shunt without associated focal lesion [Fig 17] [Fig 18]
  4. Arterioportal shunt associated with associated focal lesion [Fig 19] 
  5. Inflammation 
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