Open AccessCT during Hepatic Arteriography and Portography: An Illustrative Review
Author(s) -
Hyun Cheol Kim,
Tae Kyoung Kim,
KyuBo Sung,
Hyun Jung Yoon,
Pyo Nyun Kim,
Hyun Kwon Ha,
Ah Young Kim,
Hyun Jin Kim,
Moon-Gyu Lee
Publication year - 2002
Publication title -
radiographics
Language(s) - English
Resource type - Journals
eISSN - 1527-1323
pISSN - 0271-5333
DOI - 10.1148/radiographics.22.5.g02se071041
Subject(s) - medicine , portography , hepatocellular carcinoma , radiology , cirrhosis , hemodynamics , portal hypertension
The combination of computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) has been used for evaluation of hepatic neoplasms before partial hepatic resection. Focal hepatic lesions that can be demonstrated with CTAP and CTHA include regenerative nodules, dysplastic nodules, dysplastic nodules with malignant foci, hepatocellular carcinoma, cholangiocarcinoma, hemangioma, and metastases. CTAP is considered the most sensitive modality for detection of small hepatic lesions, particularly small hepatic tumors such as hepatocellular carcinoma and metastatic tumors. CTHA can demonstrate not only hypervascular tumors but also hypovascular tumors and can help differentiate malignant from benign lesions. However, various types of nontumorous hemodynamic changes are frequently encountered at CTAP or CTHA and appear as focal lesions that mimic true hepatic lesions. Such hemodynamic changes include several types of arterioportal shunts, liver cirrhosis, Budd-Chiari syndrome, inflammatory changes, pseudolesions due to an aberrant blood supply, and laminar flow in the portal vein. Familiarity with the CTAP and CTHA appearances of various hepatic lesions and nontumorous hemodynamic changes allows the radiologist to improve the diagnostic accuracy.