Intrahepatic arterioportal shunting and anomalous venous drainage: understanding the CT features in the liver.
The increased use of high-contrast volume, arterial-phase studies of the liver has demonstrated the frequent occurrence of arterioportal shunts within both the cirrhotic and non-cirrhotic liver. This article sets out to explain the underlying microcirculatory mechanisms behind these commonly encountered altered perfusion states. Similarly, well-recognised portal perfusion defects occur around the perifalciform and perihilar liver and are largely caused by anomalous venous drainage via the paraumbilical and parabiliary venous systems. The underlying anatomy will be discussed and illustrated. These vascular anomalies are all caused by or result in diminished portal perfusion and are often manifest in the setting of portal venous thrombosis. The evolving concept of zonal re-perfusion following portal vein thrombosis will be discussed.
Breen
David J
DJ
Department of Radiology, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, Hampshire, UK. david.breen@suht.swest.nhs.uk
Rutherford
Elizabeth E
EE
Stedman
Brian
B
Lee-Elliott
Catherine
C
Hacking
C Nigel
CN
D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008102:Liver Circulation; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008833:Microcirculation / Q000000981:diagnostic imaging / Q000503:physiopathology; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011172:Portography; D014057:Tomography, X-Ray Computed