title: Significance of CT scan and color Doppler duplex ultrasound in the assessment of Abernethy malformation.
abstract: BACKGROUND
  Abernethy malformation is a rare congenital vascular abnormality in which the portal vein bypasses the liver and drains directly into the inferior vena cava. Diagnosis is complex and requires good quality imaging methods to identify details in systemic and portal circulation in order to establish diagnostic confirmation and treatment strategy. In this study we highlight the significance of the use of CT scans and Color Doppler Duplex Ultrasound for the diagnosis, treatment and evolution assessment in two adults with Abernethy malformation.
  
  
  METHODS
  The diagnosis and the treatment of two patients with Abernethy malformation by CT scan and Color Doppler Duplex Ultrasound is described. One patient was submitted to liver transplantation due to chronic liver disease and multiple nodules diagnosed as adenoma. The other patient had normal liver function and a mild neurological and psychomotor dysfunction, therefore we adopted clinical treatment and close liver parenchyma evaluation and nodule surveillance, using an imaging approach involving intercalating CT scan and Color Doppler Duplex Ultrasound every 6 months. We highlight some important direct and indirect findings of non-invasive imaging methods.
  
  
  CONCLUSIONS
  Abernethy malformation requires meticulous image diagnosis to improve treatment and avoid iatrogenic procedures. CT scans and Color Doppler Duplex Ultrasound are both efficient methods for diagnosis, treatment planning and evolution assessment of patients with Abernethy malformation.
authors.affiliation: Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255 -9° andar -sala 9113/9114 CEP 05403-900, São Paulo, Brazil. lucasnacif@usp.br.
authors.forename: Lucas Souto
authors.initials: LS
authors.lastname: Nacif
authors.affiliation: Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255 -9° andar -sala 9113/9114 CEP 05403-900, São Paulo, Brazil. denise.paranagua@gmail.com.
authors.forename: Denise Cerqueira
authors.initials: DC
authors.lastname: Paranaguá-Vezozzo
authors.affiliation: Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255 -9° andar -sala 9113/9114 CEP 05403-900, São Paulo, Brazil. fgalvao@usp.br.
authors.forename: Flávio Henrique Ferreira
authors.initials: FH
authors.lastname: Galvão
authors.affiliation: Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255 -9° andar -sala 9113/9114 CEP 05403-900, São Paulo, Brazil. manoelrocha@usp.br.
authors.forename: Manoel S
authors.initials: MS
authors.lastname: Rocha
authors.affiliation: Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255 -9° andar -sala 9113/9114 CEP 05403-900, São Paulo, Brazil. wellington@usp.br.
authors.forename: Wellington
authors.initials: W
authors.lastname: Andraus
authors.affiliation: Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255 -9° andar -sala 9113/9114 CEP 05403-900, São Paulo, Brazil. fjcarril@usp.br.
authors.forename: Flair Jose
authors.initials: FJ
authors.lastname: Carrilho
authors.affiliation: Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255 -9° andar -sala 9113/9114 CEP 05403-900, São Paulo, Brazil. profluizcarneiro@gmail.com.
authors.forename: Luiz Carneiro
authors.initials: LC
authors.lastname: D'Albuquerque
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D054079:Vascular Malformations / Q000150:complications / Q000473:pathology*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult