Intrahepatic arterioportal shunting and anomalous venous drainage: understanding the CT features in the liver

Eur Radiol. 2004 Dec;14(12):2249-60. doi: 10.1007/s00330-004-2334-0. Epub 2004 Jun 12.

Abstract

The increased use of high-contrast volume, arterial-phase studies of the liver has demonstrated the frequent occurrence of arterioportal shunts within both the cirrhotic and non-cirrhotic liver. This article sets out to explain the underlying microcirculatory mechanisms behind these commonly encountered altered perfusion states. Similarly, well-recognised portal perfusion defects occur around the perifalciform and perihilar liver and are largely caused by anomalous venous drainage via the paraumbilical and parabiliary venous systems. The underlying anatomy will be discussed and illustrated. These vascular anomalies are all caused by or result in diminished portal perfusion and are often manifest in the setting of portal venous thrombosis. The evolving concept of zonal re-perfusion following portal vein thrombosis will be discussed.

Publication types

  • Review

MeSH terms

  • Hepatic Artery / diagnostic imaging*
  • Hepatic Artery / physiopathology
  • Humans
  • Liver / blood supply*
  • Liver / diagnostic imaging*
  • Liver Circulation
  • Liver Diseases / diagnostic imaging*
  • Liver Diseases / physiopathology
  • Microcirculation / diagnostic imaging
  • Microcirculation / physiopathology
  • Portal Vein / diagnostic imaging*
  • Portal Vein / physiopathology
  • Portography
  • Tomography, X-Ray Computed