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Imaging Findings in Incidental Intrahepatic Portal Venous Shunts

Erick M. Remer1, Gaspar A. Motta-Ramirez1 and J. Michael Henderson2

1 Division of Radiology, Cleveland Clinic Foundation, 9500 Euclid Ave., A21, Cleveland, OH 44195.
2 Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH.


Figure 1
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  		Fig. 1 —76-year-old man with history of renal cell carcinoma. Coronal oblique 3D color Doppler sonogram shows aneurysmal communication between portal vein (PV) and right hepatic vein (HV).

 

Figure 2
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  		Fig. 2 —81-year-old woman who underwent contrast-enhanced CT after repair of diaphragmatic hernia. Coronal oblique maximum intensity projection shows small aneurysmal communication (A) between branches of right portal vein (PV) and right hepatic vein (HV). Radiodense material adjacent to aneurysm is barium in adjacent colon.

 

Figure 3
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  		Fig. 3A —86-year-old woman examined because of history of renal cell carcinoma. Image from portal venous phase CT shows shunt to have appearance of hypervascular rounded lesion (arrowhead) in left hepatic lobe.

 

Figure 4
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  		Fig. 3B —86-year-old woman examined because of history of renal cell carcinoma. Slightly caudal image shows large portal vein (PV) communication. More cranial image (not shown) shows hepatic vein communication.

 

Figure 5
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  		Fig. 4A —53-year-old woman who underwent contrast-enhanced helical CT to assess for breast carcinoma metastasis. Image from 2001 shows small aneurysm connected to left portal vein.

 

Figure 6
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  		Fig. 4B —53-year-old woman who underwent contrast-enhanced helical CT to assess for breast carcinoma metastasis. Image from 2002 shows stable size of aneurysm.

 

Figure 7
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  		Fig. 4C —53-year-old woman who underwent contrast-enhanced helical CT to assess for breast carcinoma metastasis. Image from 2004 shows enlargement of aneurysm from 1.2 cm in 2001 to 2.4 cm.

 

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