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The Abernethy malformation — myriad imaging manifestations of a single entity

View Article: PubMed Central - PubMed

ABSTRACT

Abernethy malformation, also known as congenital extrahepatic portosystemic shunts (CEPS) is a rare clinical entity and manifests with different clinical symptoms. CEPS are abnormalities of vascular development where there is shunting of portal blood into the systemic venous system. Multidetector computed tomography (MDCT) is a fast and effective modality for evaluation of CEPS. CT displays all the information desired by the surgeon as well as the clinician including the anatomy of the splenic and superior mesenteric veins, size and site of the shunt, presence or absence of the portal vein radicles, and helps to plan the therapy and even the follow-up of these patients. Contrast-enhanced magnetic resonance imaging (MRI) has also emerged as a promising tool for the evaluation of liver lesions associated with the malformation. The Radiologist should be aware of the various imaging appearances of this entity including its complications. In this article, we describe the imaging appearances of CEPS, their complications, and their imaging appearances on CT and MRI. We have also described various associated anomalies.

No MeSH data available.


Related in: MedlinePlus

A 40-year-old male, presenting with liver mass, axial sections through liver in plain (A) arterial (B) and venous (C) phases show a large arterial phase enhancing lesion showing washout on delayed phase suggestive of hepatocellular carcinoma (*) (biopsy proven). There is a large well-defined fistulous communication seen between the portal vein and IVC (white arrow). The intrahepatic branches of MPV are not well seen
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Figure 7: A 40-year-old male, presenting with liver mass, axial sections through liver in plain (A) arterial (B) and venous (C) phases show a large arterial phase enhancing lesion showing washout on delayed phase suggestive of hepatocellular carcinoma (*) (biopsy proven). There is a large well-defined fistulous communication seen between the portal vein and IVC (white arrow). The intrahepatic branches of MPV are not well seen

Mentions: The imaging findings in patients with Abernethy malformation with Hepatocellular carcinoma do not appear to be typical, that is hypervascularity on the arterial phase images with washout on delayed phase. [Figure 7]. Thus, patients who do not have typical findings of a benign lesion, i.e. lack of arterial enhancement, or arterial enhancement without washout, should be closely followed up or biopsied.


The Abernethy malformation — myriad imaging manifestations of a single entity
A 40-year-old male, presenting with liver mass, axial sections through liver in plain (A) arterial (B) and venous (C) phases show a large arterial phase enhancing lesion showing washout on delayed phase suggestive of hepatocellular carcinoma (*) (biopsy proven). There is a large well-defined fistulous communication seen between the portal vein and IVC (white arrow). The intrahepatic branches of MPV are not well seen
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036336&req=5

Figure 7: A 40-year-old male, presenting with liver mass, axial sections through liver in plain (A) arterial (B) and venous (C) phases show a large arterial phase enhancing lesion showing washout on delayed phase suggestive of hepatocellular carcinoma (*) (biopsy proven). There is a large well-defined fistulous communication seen between the portal vein and IVC (white arrow). The intrahepatic branches of MPV are not well seen
Mentions: The imaging findings in patients with Abernethy malformation with Hepatocellular carcinoma do not appear to be typical, that is hypervascularity on the arterial phase images with washout on delayed phase. [Figure 7]. Thus, patients who do not have typical findings of a benign lesion, i.e. lack of arterial enhancement, or arterial enhancement without washout, should be closely followed up or biopsied.

View Article: PubMed Central - PubMed

ABSTRACT

Abernethy malformation, also known as congenital extrahepatic portosystemic shunts (CEPS) is a rare clinical entity and manifests with different clinical symptoms. CEPS are abnormalities of vascular development where there is shunting of portal blood into the systemic venous system. Multidetector computed tomography (MDCT) is a fast and effective modality for evaluation of CEPS. CT displays all the information desired by the surgeon as well as the clinician including the anatomy of the splenic and superior mesenteric veins, size and site of the shunt, presence or absence of the portal vein radicles, and helps to plan the therapy and even the follow-up of these patients. Contrast-enhanced magnetic resonance imaging (MRI) has also emerged as a promising tool for the evaluation of liver lesions associated with the malformation. The Radiologist should be aware of the various imaging appearances of this entity including its complications. In this article, we describe the imaging appearances of CEPS, their complications, and their imaging appearances on CT and MRI. We have also described various associated anomalies.

No MeSH data available.


Related in: MedlinePlus