Focal sparing of segment IV in fatty livers shown by sonography and CT: correlation with aberrant gastric venous drainage.

Matsui, Osamu; Kadoya, Masumi; Takahashi, Shirō; Yoshikawa, Jun; Gabata, Toshifumi; Takashima, Tsutomu; Kitagawa, Kiyotaka

doi:10.2214/ajr.164.5.7717220

Cited by 133 publications

(73 citation statements)

References 3 publications

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“…50 In support of this hypothesis, changes in vascular flow within the liver have been shown to be responsible for focal sparing of segment 4 of otherwise-fatty livers. 51 The development of histological NASH 2 years after transplantation in 1 of our diabetic, cryptogenic patients and subsequent progression after 2 more years to nonsteatotic ''bland'' cirrhosis is consistent with this type of progression.…”

Section: Discussionsupporting

confidence: 66%

Cryptogenic Cirrhosis: Clinical Characterization and Risk Factors for Underlying Disease

et al. 1999

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We characterized 70 consecutive patients with cryptogenic cirrhosis to assess major risks for liver disease. Each patient was reevaluated for past alcohol exposure, scored by the International Autoimmune Hepatitis (IAH) score and assessed for viral hepatitis risks and risks for nonalcoholic steatohepatitis (NASH). The results were compared with 50 consecutive NASH patients, 39 nonalcoholic patients age 50 and over with cirrhosis from hepatitis C, and 33 consecutive patients with cirrhosis caused by primary biliary cirrhosis (PBC). Among the cryptogenic group, 49 (70%) were female, and the mean age was 63 ؎ 11 years. Although ascites and variceal bleeding were common, almost one half lacked major signs of complicated portal hypertension. A history of Type 2 diabetes mellitus and/or obesity was present in 51 (73%). Nineteen (27%) patients had a history of blood transfusions antedating the diagnosis of cirrhosis. No clinical or histological features distinguished this group from the other patients, and 14 (74%) of these had a history of obesity and/or diabetes. Nineteen of the remaining nontransfused patients had indeterminant IAH scores but were histologically and biochemically indistinguishable from the others. Twelve of these (63%) also had a history of obesity and/or diabetes. Both diabetes and obesity were significantly more common in the cryptogenic cirrhotic patients compared with the cirrhotic patients with PBC or hepatitis C. In contrast, the prevalence of obesity and diabetes was similar to the NASH patients who were, on average, a decade younger. Although there is some diversity that indicates more than one cause, our findings suggest that NASH plays an under-recognized role in many patients with cryptogenic cirrhosis, most of whom are older, type 2 diabetic and obese females. (HEPATOLOGY 1999;29:664-669.)

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Section: Discussionsupporting

confidence: 66%

Cryptogenic Cirrhosis: Clinical Characterization and Risk Factors for Underlying Disease

et al. 1999

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“…6 According to Couinaud, the caudate lobe receive a specific pedicle independent of the portal vein and the right gastric vein (or pyloric vein) or parabiliary venous system occasionally drain directly into the posterior edge of the medial segment (segment IV) or the caudate lobe (segment I). 7 It is reported that the segment involved with aberrant venous drainage may show various morphologic changes, including focal spared area in fatty liver, 8,9 focal fatty infiltration, 10 and hyperplastic change 11 etc. So, liver biopsy often perform to distinguish from malignant mass.…”

Section: Discussionmentioning

confidence: 99%

Giant Hyperplasia of the Caudate Lobe in a Patient with Liver Cirrhosis: Case Report and Literature Review

Choi

Jun²,

Lee³

et al. 2008

Gut Liver

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The caudate lobe often exhibits enlargement and nodularity in cases of cirrhosis, which makes differentiation of hepatocellular carcinoma from other masslike lesions of the caudate lobe difficult in cirrhotic patients. A 12×6 cm mass-like enlargement of the caudate lobe was incidentally found by computed tomography in a 38-year-old man suffering from alcoholic liver cirrhosis. Magnetic resonance imaging, liver colloidal scan, and sonoguided liver biopsy were used for the differential diagnosis. A literature review revealed two case reports, all of which (like ours) presented with an enlarged caudate lobe supplied with blood via a branch of the portal vein. Therefore, in cases of giant hyperplasia of the caudate lobe, confirmation of the caudate lobe blood supply and the enhancement pattern might be important for the differentiation. (Gut and Liver 2008;2:205-208)

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“…He reported in an anatomic study that the right gastric vein (or pyloric vein) or parabiliary venous system occasionally drain directly into the posterior edge of the medial segment (segment IV) or the caudate lobe (segment I). We have reported that the segment involved with aberrant venous drainage may show various histologic changes, including focal-spared area in fatty liver [8,9], focal fatty infiltration [10], and hyperplastic change in cirrhotic liver [11]. The areas with hyperplastic change are hypodense on CT, hyperintense on T1-weighted magnetic resonance (MR) images, and hypointense on T2-weighted images and show decreased portal blood supply on CTAP [11].…”

Section: Discussionmentioning

confidence: 99%

Giant hyperplasia of the caudate lobe of the cirrhotic liver: correlation with an anomaly of the caudate portal branch

et al. 1999

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Different imaging appearances of giant hyperplastic change of the caudate lobe of the liver are presented in a patient with liver cirrhosis. The mass like caudate lobe was isoechoic on ultrasound, hypodense on postcontrast computed tomography (CT), hyperintense on T1-weighted magnetic resonance, images and isointense on T2-weighted images. These imaging findings are similar to those of dysplastic nodule in cirrhotic liver. The caudate lobe received normal portal flow on CT during arterial portography, but superior mesenteric arteriography showed precocious or early division of the caudate portal branch. We suspect that caudate hyperplastic change may be correlated to anomalous caudate portal vein branch.

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Focal sparing of segment IV in fatty livers shown by sonography and CT: correlation with aberrant gastric venous drainage.

Cited by 133 publications

References 3 publications

Cryptogenic Cirrhosis: Clinical Characterization and Risk Factors for Underlying Disease

Cryptogenic Cirrhosis: Clinical Characterization and Risk Factors for Underlying Disease

Giant Hyperplasia of the Caudate Lobe in a Patient with Liver Cirrhosis: Case Report and Literature Review

Giant hyperplasia of the caudate lobe of the cirrhotic liver: correlation with an anomaly of the caudate portal branch

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