Imaging Manifestations of Idiopathic Hepatic Arteriovenous Malformation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xie ¹ , SONG Bin ¹ , YUAN Fang ¹ , CHEN Guangwen ² , HUANG Zixing. ¹

1.Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041,China;;
2.Department of Radiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu 610072, China;

Corresponding author：

Keywords：

Liver; Arteriovenous malformation; Tomography/X-ray computed; Magnetic resonance imaging

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Objective To investigate the imaging features of idiopathic hepatic arteriovenous malformation（IHAVM） on multi-detector row spiral CT (MDCT) and magnetic resonance imaging (MRI). Methods Nineteen patients with IHAVM between January 2009 and June 2010 were included for retrospective analysis of the imaging findings on MDCT (n=9) and MRI (n=10), especially the imaging features of IHAVM on contrast-enhanced dynamic scans. Results All IHAVM lesions in 9 patients were isodense in plain scan of MDCT, and showed marked small nodular or linear enhancement with similar intensity to vascular enhancement in arterial phase, and the enhancement continued to persist to portal phase but with reduced enhancement degree. Early visualization of venous tributaries in arterial phase was present in 4 cases, and wedge-shaped or lamellar transient hepatic parenchyma enhancement in arterial phase in the edge of the lesion was observed in 6 cases. In 10 patients with MRI scan, the enhancement patterns of IHAVM were quite similar to the findings on MDCT, with early visualization of venous tributaries in arterial phase in 5 cases and wedge-shaped transient hepatic parenchyma enhancement in arterial phase in the edge of the IHAVM lesion in 7 cases. Conclusion Contrast-enhanced multi-phase MDCT and MRI scans can depict the morphologic and hemodynamic characteristics of IHAVM, thus they are very valuable for the diagnosis of IHAVM.

Citation： ZHANG Xie,SONG Bin,YUAN Fang,CHEN Guangwen,HUANG Zixing.. Imaging Manifestations of Idiopathic Hepatic Arteriovenous Malformation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(11): 1207-1212. doi: Copy

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3.	Nishimori A, Okajima H, Okumura K, et al. Living donor liver transplantation as a means of rescuing post-embolization hepatic failure in a patient with idiopathic intrahepatic arteriovenous malformation in the liver [J]. J Hepatobiliary Pancreat Surg, 2009; 16(3): 382-385.
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9.	欧阳墉, 欧阳雪晖, 顾苏宾, 等. 成人肝海绵状血管瘤并发动静脉短路的DSA检查和诊断 [J]．中华放射学杂志， 2000; 34(8): 523-527．.
10.	郭启勇. 实用放射学 [M]. 北京: 人民卫生出版社, 2009: 804-808.
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12.	Catalano O, Siani A. Peripheral arterioportal fistula: demonstration with contrast-enhanced sonography [J]． J Ultrasound Med, 2005; 24(7): 1027-1030.
13.	Zandrino F, Curone P, Benzi L, et al. Value of an early arteriographic acquisition for evaluating the splanchnic vessels as an adjunct to biphasic CT using a multislice scanner [J]. Eur Radiol, 2003; 13(5): 1072-1079.
14.	张龙江，宋光义，包颜明，等. 肝脏血管解剖和变异的多层螺旋CT血管成像研究 [J]. 中华放射学杂志, 2005; 39(9): 963-967.
15.	Rofsky NM, Lee VS, Laub G, et al. Abdominal MR imaging with a volumetric interpolated breath-hold examination [J]． Radiology, 1999; 212(3): 876-884.
16.	宋彬，闵鹏秋，吴苾, 等. 磁共振VIBE序列鉴别胰腺癌与肿块型慢性胰腺炎的价值探讨 [J]. 放射学实践, 2006; 21(5): 498-502.
17.	邬颖华, 宋彬, 徐隽. MRI VIBE序列动态增强对肝脏局灶性病变的诊断价值 [J]. 中国普外基础与临床杂志, 2006; 13(2): 227-232.

1. Choi BI, Chung JW, Itai Y, et al. Hepatic abnormalities related to blood flow: evaluation with dual-phase helical CT [J]. Abdom Imaging, 1999; 24(4): 340-356.
2. Adaletli I, Kurugoglu S, Kilic F, et al. Radiological evaluation with Doppler sonography and multidetector CT angiography in congenital hepatic arteriovenous malformation in a newborn [J]. Pediatr Radiol, 2006; 36(11): 1204-1207.
3. Nishimori A, Okajima H, Okumura K, et al. Living donor liver transplantation as a means of rescuing post-embolization hepatic failure in a patient with idiopathic intrahepatic arteriovenous malformation in the liver [J]. J Hepatobiliary Pancreat Surg, 2009; 16(3): 382-385.
4. 吴春，姜在波，李名安, 等. 肝脏特发性肝动脉-门静脉畸形1例 [J]. 当代医学， 2009; 15（11）: 251-252.
5. Torabi M, Hosseinzadeh K, Federle MP. CT of nonneoplastic hepatic vascular and perfusion disorders [J]. Radiographics, 2008; 28(7): 1967-1982.
6. Choi BI, Lee KH, Han JK, et al. Hepatic arterioportal shunts: dynamic CT and MR features [J]. Korean J Radiol, 2002; 3(1): 1-15.
7. Tian JL, Zhang JS. Hepatic perfusion disorders: etiopathogenesis and related diseases [J]. World J Gastroenterol, 2006; 12(20): 3265-3270.
8. Kim KW, Kim TK, Han JK, et al. Hepatic hemangiomas with arterioportal shunt: findings at two-phase CT [J]． Radiology, 2001; 219(3): 707-711.
9. 欧阳墉, 欧阳雪晖, 顾苏宾, 等. 成人肝海绵状血管瘤并发动静脉短路的DSA检查和诊断 [J]．中华放射学杂志， 2000; 34(8): 523-527．.
10. 郭启勇. 实用放射学 [M]. 北京: 人民卫生出版社, 2009: 804-808.
11. Choi CS, Freeny PC. Triphasic helical CT of hepatic focal nodular hyperplasia: incidence of atypical findings [J]. AJR Am J Roentgenol, 1998; 170(2): 391-395.
12. Catalano O, Siani A. Peripheral arterioportal fistula: demonstration with contrast-enhanced sonography [J]． J Ultrasound Med, 2005; 24(7): 1027-1030.
13. Zandrino F, Curone P, Benzi L, et al. Value of an early arteriographic acquisition for evaluating the splanchnic vessels as an adjunct to biphasic CT using a multislice scanner [J]. Eur Radiol, 2003; 13(5): 1072-1079.
14. 张龙江，宋光义，包颜明，等. 肝脏血管解剖和变异的多层螺旋CT血管成像研究 [J]. 中华放射学杂志, 2005; 39(9): 963-967.
15. Rofsky NM, Lee VS, Laub G, et al. Abdominal MR imaging with a volumetric interpolated breath-hold examination [J]． Radiology, 1999; 212(3): 876-884.
16. 宋彬，闵鹏秋，吴苾, 等. 磁共振VIBE序列鉴别胰腺癌与肿块型慢性胰腺炎的价值探讨 [J]. 放射学实践, 2006; 21(5): 498-502.
17. 邬颖华, 宋彬, 徐隽. MRI VIBE序列动态增强对肝脏局灶性病变的诊断价值 [J]. 中国普外基础与临床杂志, 2006; 13(2): 227-232.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Imaging Manifestations of Idiopathic Hepatic Arteriovenous Malformation

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