Evaluation of hepatic perfusion disorders with double-phase spiral CT.

Gryspeerdt, Stefaan; Hoe, Lieven Van; Marchal, Guy; Baert, A L

doi:10.1148/radiographics.17.2.9084076

Cited by 57 publications

(63 citation statements)

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“…Angiographic findings included non-opacification of portal vein (a sign of intrahepatic portal vein obstruction) on portograms or wedge-shaped segmental staining in arterial and parenchymal phases on hepatic angiograms, and corresponding features are seen if there is an occlusion of hepatic vein or aberrant blood supply. There lacks special report of US features about HPD yet, trapezoid hypoechoic areas on US were found corresponding to SID on MR or THAD on CT images [6] . There is also no report about real-time contrast-enhanced US features of HPD as yet.…”

Section: Imaging Featuresmentioning

confidence: 96%

“…They also found that many cases with wedgeshaped defects showed by portography and segmental staining on arteriography revealed no areas of low attenuation on plain CT and MR images and no pathologic dif-ferences at microscpic examination. In 1997, Gryspeerdt et al [6] reviewed the phenomenon of hepatic perfusion differences on dual-phase spiral CT scan, and first nominated it as hepatic perfusion disorders (HPDs). They considered that various HPDs are related to portal venous inflow obstruction, hepatic venous outflow obstruction (e.g., BuddChiari syndrome, cardiac failure, mediastinal fibrosis), mediastinal or thoracic venous inlet obstruction, focal liver lesions, inflammatory processes, normal anatomic variants in the hepatic blood supply, altered hemodynamics after the placement of a transjugular intrahepatic portosystemic shunt, and uncertain causes.…”

Section: Nomenclature and Historymentioning

confidence: 99%

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Hepatic perfusion disorders: Etiopathogenesis and related diseases

Hui

Zhang²

2006

WJG

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In this article, we have reviewed the hepatic perfusion d i s o r d e r ( H P D ) , e t i o p a t h o g e n e s i s o f H P D a n d corresponding diseases. Review of the literature was based on computer searches (PubMed, Index Medicus) and personal experiences. We considered HPD reflects perfusion differences due to redistribution of arterial blood flow among segments, subsegments and lobes of the liver. The plain CT scan findings of HPD manifests as triangular or wedge-shaped areas of low attenuation. On contrast-enhanced CT scan, HPD manifests multiple (or single) transient wedge-shaped, rotundloid or irregular appearance, homogeneous hyperattenuation (in less cases, hypoattenuation) during the hepatic arterial phase (HAP) and isoattenuated or slightly hyperattenuated areas during the portal arterial phase. Dynamic enhanced magnetic resonance (MR) features are similar to enhanced CT scan. Angiographic findings include non-opacification of portal vein on portograms or wedge-shaped segmental staining in arterial and parenchymal phases on hepatic angiograms. The causes of HPD are arterioportal shunts (APS), intrahepatic vascular compressions and portal vein occlusion, steal phenomenon by hypervascular tumors, vascular variations and any other unknown reasons. It is very important for radiologists to be familiar with the various appearances of HPD to avoid false-positive diagnosis of pseudolesions and not to overestimate the extent of the disease.

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Section: Imaging Featuresmentioning

confidence: 96%

Section: Nomenclature and Historymentioning

confidence: 99%

Hepatic perfusion disorders: Etiopathogenesis and related diseases

Hui

Zhang²

2006

WJG

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“…TPHE indicates an increase in arterial perfusion, due to a variation of the normal hepatic blood supply. THPE is generally observed as an area of hyperdensity/hyperintensity (then with appearance brighter than surrounding areas) in the parenchyma in the arterial phase, which tends to disappear during the portal phase [8,9].…”

Section: Definitionmentioning

confidence: 99%

Transient Hepatic Parenchymal Enhancement detected at dynamic imaging: A short instruction manual for the clinician

Colagrande

Pradella

Lucarini

et al. 2012

Digestive and Liver Disease

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a b s t r a c tBasic knowledge in the interpretation of hepatic imaging is essential for the clinical hepatologist. In recent years, the availability of dynamic imaging studies of the liver using computed tomography or magnetic resonance has led to appreciate the importance of early changes in arterial perfusion for the interpretation of hepatic lesions. Transient Hepatic Parenchymal Enhancement (THPE) is defined as a normal area of liver parenchyma that enhances after injection of contrast agent during the arterial phase of perfusion. Appearance of this sign is mostly associated with a reduction in portal perfusion or with inflammation, and appears in different morphologic patterns. THPE should not be considered a radiological artefact, and its interpretation is essential to avoid misclassification of hepatic lesions that may have clinical significance, such as hepatocellular carcinoma or hepatic metastases. In this short review we provide essential information on the causes, pathophysiology and morphology of THPE, and discuss the relevance of these findings in a clinical perspective.

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“…Na oclusão da veia cava superior (VCS), o fluxo dos membros superiores segue vias acessórias, como o sistema ázigos-hemiá-zigos, o plexo venoso vertebral, as veias mamárias internas e torácicas laterais (11,12) .…”

Section: -Alterações Perfusionais Focais Por Obstrução Da Veia Cava Sunclassified

Pseudolesões hepáticas na tomografia computadorizada helicoidal: ensaio iconográfico

Meirelles

D'Ippólito

2003

Radiol Bras

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INTRODUÇÃONos dias atuais, a tomografia computadorizada (TC) é um método rotineiro na avaliação do fígado, com ampla aceitação para a detecção e caracterização de tumores e com grande importância no planejamento clínico-cirúrgico e no prognóstico da doença(1) . O advento dos aparelhos de TC helicoidais resultou em importante melhora na avaliação hepática, ao demonstrar, com maior eficácia, lesões parenquimatosas, o que levou a uma maior utilização do mé-todo. No entanto, várias armadilhas diagnósticas surgiram, principalmente ligadas a defeitos de perfusão decorrentes da rá-pida injeção do meio de contraste e aquisição das imagens, dificultando a análise e prejudicando a diferenciação entre lesões e pseudolesões(1-4) . Consideramos pseudolesões hepáticas aquelas imagens que simulam lesões hepá-ticas focais, podendo levar a diagnósticos equivocados. O objetivo deste estudo é apresentar uma revisão dessas pseudolesões, propondo uma classificação sistemá-tica por meio de casos ilustrativos e estratégias para diferenciá-las de lesões parenquimatosas. CLASSIFICAÇÃO DAS PSEUDOLESÕES HEPÁTICASVárias são as pseudolesões hepáticas encontradas na TC helicoidal. As principais encontram-se listadas no Quadro 1.A tomografia computadorizada helicoidal é largamente empregada na avaliação do parênquima hepático e tem grande importância no planejamento clínico e cirúrgico. O fígado é o órgão que mais se beneficia de aquisições helicoidais, em fases diferentes da perfusão do parênquima, pela sua dupla vascularização e pela diferença de aporte sanguíneo entre tumores e parênquima sadio. Entretanto, várias armadilhas diagnósti-cas podem ser encontradas, dificultando a análise e prejudicando a diferenciação entre lesões verdadeiras e pseudolesões, principalmente aos olhos de radiologistas menos experientes. Essas pseudolesões têm forma, localização e características variadas, podendo simular lesões parenquimatosas. É de fundamental importância que estejamos aptos a reconhecê-las, no sentido de interpretar corretamente as imagens tomográfi-cas. O objetivo deste ensaio é classificar e ilustrar as diversas pseudolesões hepáticas pela tomografia computadorizada helicoidal, com uma breve descrição dessas lesões e com alternativas para diferenciá-las das lesões do parênquima. Unitermos: Fígado; Tomografia computadorizada helicoidal; Erros de diagnóstico.Helical computed tomography of hepatic pseudolesions: a pictorial essay. Helical computed tomography has been widely used in the evaluation of the liver parenchyma for clinical and surgical management. The liver is probably the organ for which helical computed tomography examination is best indicated due to hepatic dual blood perfusion and the difference in blood supply between liver tumors and normal parenchyma. However, there are pitfalls in the interpretation of the images that may impair differentiation of true lesions from pseudolesions, particularly for the inexperienced radiologist. These pseudolesions present different shapes, location and characteristics that may mimic parenchymal...

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Evaluation of hepatic perfusion disorders with double-phase spiral CT.

Cited by 57 publications

References 0 publications

Hepatic perfusion disorders: Etiopathogenesis and related diseases

Hepatic perfusion disorders: Etiopathogenesis and related diseases

Transient Hepatic Parenchymal Enhancement detected at dynamic imaging: A short instruction manual for the clinician

Pseudolesões hepáticas na tomografia computadorizada helicoidal: ensaio iconográfico

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