Hepatic hemangiomas with arterioportal shunt: findings at two-phase CT.
OBJECTIVE
To determine the prevalence of arterioportal shunt associated with hepatic hemangiomas, describe the two-phase spiral computed tomographic (CT) findings, and correlate the presence of arterioportal shunt with the size and rapidity of enhancement of hemangiomas.


METHODS
The study group consisted of 109 hepatic hemangiomas in 69 patients who underwent two-phase spiral CT during 1 year. CT scans were obtained during the hepatic arterial (30-second delay) and portal venous (65-second delay) phases after injection of 120 mL of contrast material (3 mL/sec). Arterioportal shunts were diagnosed when hepatic arterial phase CT scans showed a wedge-shaped or irregularly shaped homogeneous enhancement in the liver parenchyma adjacent to the tumor and when portal venous phase CT scans showed isoattenuation or slight hyperattenuation, compared with normal liver in that area, and when there was no demonstrable cause of these attenuation differences. The presence of arterioportal shunt in hemangioma was correlated with the size of the tumor and the rapidity of intratumoral enhancement.


RESULTS
Arterioportal shunt was found in 28 (25.7%) of 109 hemangiomas. There was no statistically significant relationship between lesion size and presence of the arterioportal shunt (P =.653). Arterioportal shunt was more frequently found in hemangiomas with rapid enhancement (P <.01).


CONCLUSIONS
Arterioportal shunts are not uncommonly seen in hepatic hemangiomas at two-phase spiral CT. Hemangiomas with arterioportal shunts tend to show rapid enhancement.
Kim
K W
KW
Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Korea.
Kim
T K
TK
Han
J K
JK
Kim
A Y
AY
Lee
H J
HJ
Choi
B I
BI
D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000000981:diagnostic imaging*; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*