[Imaging findings of pulmonary vascular disorders in portal hypertension].
OBJECTIVE
The purpose of this study was to demonstrate and compare the imaging findings of hepatopulmonary syndrome and portopulmonary hypertension.


METHODS
We retrospectively reviewed the imaging findings of five patients with hepatopulmonary syndrome and four patients with portopulmonary hypertension. We evaluated chest radiographs, chest and abdominal computed tomography (CT) scans, 99mTc-macroaggregated albumin (MAA) lung perfusion scans, and pulmonary angiograms.


RESULTS
In patients with hepatopulmonary syndrome, the presence of peripheral pulmonary vascular dilatation was detected by chest radiograph, chest CT scan, and pulmonary angiogram, especially the basilar segment. 99mTc-MAA lung perfusion scan showed extrapulmonary tracer distribution (brain, thyroid, and kidney), which revealed pulmonary R-L shunting. In patients with portopulmonary hypertension, chest radiographs and chest CT scans showed the classic findings of primary pulmonary hypertension. In patients with both disorders, extrahepatic features of portal hypertension including ascites, splenomegaly, and portosystemic collateral vessels were seen on abdominal CT.


CONCLUSIONS
In conclusion, chest radiographs and CT in hepatopulmonary syndrome usually showed peripheral pulmonary vascular dilatation, whereas those in portopulmonary hypertension showed central pulmonary artery dilatation. The extrahepatic features of portal hypertension might be helpful for the diagnosis of both disorders.
Nagasawa
Kenichi
K
Department of Radiology, Asahikawa Medical College.
Takahashi
Koji
K
Furuse
Makoto
M
Yamada
Tomonori
T
Mineta
Masayuki
M
Yamamoto
Wakako
W
Inaoka
Tsutomu
T
Hirota
Hatsune
H
Sato
Hiroaki
H
Aburano
Tamio
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003952:Diagnostic Imaging; D004108:Dilatation, Pathologic; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000175:diagnosis*; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000473:pathology; D012189:Retrospective Studies; D013577:Syndrome