Prevalence, characteristics, and fate of intrahepatic nontumorous arterioportal shunts on MRI in patients with hepatic steatosis.
OBJECTIVE
To assess the frequency, characteristics, and fate of arterioportal shunts in patients with hepatic steatosis and to compare this to the frequency in patients without liver disease.


METHODS
Eighty-four patients with hepatic steatosis but no other known liver disease and who underwent 2 abdominal magnetic resonance imaging (MRI) examinations at least 1 year apart formed one study cohort. Eighty-four subjects without steatosis or other known liver disease and who also underwent 2 MRI examinations at least 1 year apart formed a control group. Two radiologists evaluated the initial study for the presence and characteristics of arterial enhancing foci not visible on other sequences and assessed the fate of these foci on the follow-up study.


RESULTS
Of the patients with steatosis, 36.9% (95% confidence interval [CI], 26.6%-48.1%) demonstrated a total of 108 arterial enhancing foci, compared with 20 arterial enhancing foci in 13.1% of controls (95% CI, 6.7%-22.2%). Both the number of subjects with at least one arterial enhancing focus and the mean number per subject were significantly greater in the steatosis cohort (P < 0.001). The arterial enhancing foci were generally small and peripheral in location in both cohorts. On follow-up examination, all lesions disappeared, decreased in size, were stable, or increased slightly in size while remaining inconspicuous on other sequences.


CONCLUSIONS
Findings consistent with arterioportal shunts were observed at an unexpectedly high frequency in the control group but at a significantly greater frequency in the steatosis group. All foci exhibited benign behavior on long-term follow-up. Future studies may assess for clinical implications of this finding in patients with hepatic steatosis.
Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA.
Natasha E
NE
Wehrli
Thais C
TC
Mussi
Andrew B
AB
Rosenkrantz
D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D003287:Contrast Media; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000473:pathology*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D011169:Portal Vein; D015995:Prevalence; D012189:Retrospective Studies
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA