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Incidental Nonneoplastic Hypervascular Lesions in the Noncirrhotic Liver: Diagnosis with 16-MDCT and 3D CT Angiography

Ihab R. Kamel1, Eleni Liapi1 and Elliot K. Fishman1

1 All authors: Russell H. Morgan Department of Radiology, Johns Hopkins School of Medicine, 601 N Caroline St., Ste. 3235A, Baltimore, MD 21287.


Figure 1
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  		Fig. 1A —79-year-old woman with hepatic artery aneurysm. Conventional axial CT scan in arterial phase reveals small hypervascular lesions (arrow) abutting left hepatic artery (arrowheads) in left lobe of liver.

 

Figure 2
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  		Fig. 1B —79-year-old woman with hepatic artery aneurysm. Axial oblique maximum-intensity-projection image confirms presence of saccular aneurysm (arrow) arising from left hepatic artery.

 

Figure 3
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  		Fig. 2 —50-year-old woman with transient perfusion change after biopsy. Coronal maximum-intensity-projection image in arterial phase shows wedge-shaped transient subsegmental enhancement (arrow) at site of needle biopsy.

 

Figure 4
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  		Fig. 3A —41-year-old woman with arterioportal fistula. See also Figure S3C, cine loop, in supplemental data online. Conventional axial CT scan in arterial phase shows early enhancement and distention of left portal vein (arrow).

 

Figure 5
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  		Fig. 3B —41-year-old woman with arterioportal fistula. See also Figure S3C, cine loop, in supplemental data online. Coronal maximum-intensity-projection image in arterial phase shows arterioportal fistula between left hepatic artery (arrowhead) and left portal vein (arrow).

 

Figure 6
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  		Fig. 4A —25-year-old man with arterioportal fistula after biopsy. Conventional axial CT scan in arterial phase shows early enhancement of left portal vein (arrow) and increased perfusion of left hepatic lobe.

 

Figure 7
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  		Fig. 4B —25-year-old man with arterioportal fistula after biopsy. Coronal maximum-intensity-projection image in arterial phase shows arterioportal fistula between left hepatic artery (arrowhead) and left portal vein (arrow).

 

Figure 8
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  		Fig. 5A —72-year-old woman with arterioportal fistula after biopsy. Conventional axial CT scan in arterial phase shows small hypervascular lesions (arrow) abutting left hepatic artery (arrowhead) in left lobe of liver.

 

Figure 9
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  		Fig. 5B —72-year-old woman with arterioportal fistula after biopsy. Coronal maximum-intensity-projection image in arterial phase shows arterioportal fistula between left hepatic artery (arrowhead) and left portal vein, which contains varix (arrow).

 

Figure 10
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  		Fig. 6A —60-year-old woman with spontaneous arteriovenous malformation. See also Figure S6D, cine loop, in supplemental data online. Coronal (A) and axial (B) maximum-intensity-projection images in arterial phase show grapelike hypervascular lesions (arrows) in dome of liver supplied by branches of hepatic artery. Surrounding increased perfusion is evident.

 

Figure 11
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  		Fig. 6B —60-year-old woman with spontaneous arteriovenous malformation. See also Figure S6D, cine loop, in supplemental data online. Coronal (A) and axial (B) maximum-intensity-projection images in arterial phase show grapelike hypervascular lesions (arrows) in dome of liver supplied by branches of hepatic artery. Surrounding increased perfusion is evident.

 

Figure 12
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  		Fig. 6C —60-year-old woman with spontaneous arteriovenous malformation. See also Figure S6D, cine loop, in supplemental data online. Coronal maximum-intensity-projection image in portal venous phase shows persistent enhancement of lesions that drain into right hepatic vein (arrow).

 

Figure 13
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  		Fig. 7A —85-year-old woman with spontaneous venous malformation. Axial CT scan in arterial phase shows small, well-defined enhancing lesions (arrows) in left lobe.

 

Figure 14
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  		Fig. 7B —85-year-old woman with spontaneous venous malformation. Axial portal venous phase image shows persistence of lesions (arrows).

 

Figure 15
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  		Fig. 7C —85-year-old woman with spontaneous venous malformation. Axial oblique maximum-intensity-projection image in arterial phase shows tubular venous malformation arising from left portal vein (arrow).

 

Figure 16
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  		Fig. 8A —65-year-old man with spontaneous hepatic artery aneurysms and portosystemic venous shunt. See also Figure S8C, cine loop, in supplemental data online. Coronal maximum-intensity-projection image in arterial phase shows small aneurysms of hepatic artery (arrows).

 

Figure 17
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  		Fig. 8B —65-year-old man with spontaneous hepatic artery aneurysms and portosystemic venous shunt. See also Figure S8C, cine loop, in supplemental data online. Axial maximum-intensity-projection image in portal venous phase shows branch of posterior right portal vein (arrow) draining into large right hepatic vein (arrowhead).

 

Figure 18
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  		Fig. 9A —81-year-old man with spontaneous portosystemic venous shunt. Coronal maximum-intensity-projection image in portal venous phase shows direct communication between left portal vein (arrow) and left hepatic vein (arrowhead).

 

Figure 19
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  		Fig. 9B —81-year-old man with spontaneous portosystemic venous shunt. Axial (B) and coronal (C) volume-rendered images in portal venous phase show large tubular vascular channel (arrow, B; arrowhead, C) draining into left hepatic vein and inferior vena cava.

 

Figure 20
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  		Fig. 9C —81-year-old man with spontaneous portosystemic venous shunt. Axial (B) and coronal (C) volume-rendered images in portal venous phase show large tubular vascular channel (arrow, B; arrowhead, C) draining into left hepatic vein and inferior vena cava.

 

Figure 21
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  		Fig. 10 —73-year-old man with spontaneous portosystemic venous shunt. Axial maximum-intensity-projection image in portal venous phase shows direct communication between right portal vein (arrow) and right hepatic vein (arrowhead).

 

Figure 22
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  		Fig. 11 —62-year-old man with superior vena caval obstruction. Axial image in arterial phase shows early hepatic enhancement (arrow) adjacent to falciform ligament and collaterals along anterior abdominal wall.

 

Figure 23
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  		Fig. 12A —45-year-old man with superior vena caval obstruction. Coronal volume-rendered image in arterial phase shows collateral vessels along right anterior chest wall and along diaphragm.

 

Figure 24
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  		Fig. 12B —45-year-old man with superior vena caval obstruction. Axial maximum-intensity-projection image in arterial phase shows early hepatic enhancement (arrow) adjacent to falciform ligament.

 

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