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Arterioportal Shunt: Prevalence in Small Hemangiomas versus That in Hepatocellular Carcinomas 3 cm or Smaller at Two-Phase Helical CT¹

¹ From the Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Received June 19, 2003; revision requested August 27; revision received November 25; accepted January 12, 2004. Address correspondence to T.K.K., Department of Medical Imaging, Toronto General Hospital, 200 Elizabeth St, Toronto, ON, Canada M5G 2C4 (e-mail: taekyoung.kim@uhn.on.ca).

View larger version (138K): [in a new window]   Figure 1a. Transverse CT scans in 59-year-old man with hemangioma accompanied by AP shunt. (a, b) Consecutive HAP CT scans show small hyperattenuating mass (thick solid arrows in b) in posterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (thin solid arrows in a and b) adjacent to the mass. Branch of right portal vein (open arrow in a and b) in wedge-shaped homogeneously hyperattenuating area shows early enhancement that suggests presence of AP shunt. (c, d) Consecutive PVP CT scans show the still-hyperattenuating mass (thick arrows in d) and the peripheral wedge-shaped hyperattenuating area (thin arrows in c and d).

View larger version (137K): [in a new window]   Figure 1b. Transverse CT scans in 59-year-old man with hemangioma accompanied by AP shunt. (a, b) Consecutive HAP CT scans show small hyperattenuating mass (thick solid arrows in b) in posterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (thin solid arrows in a and b) adjacent to the mass. Branch of right portal vein (open arrow in a and b) in wedge-shaped homogeneously hyperattenuating area shows early enhancement that suggests presence of AP shunt. (c, d) Consecutive PVP CT scans show the still-hyperattenuating mass (thick arrows in d) and the peripheral wedge-shaped hyperattenuating area (thin arrows in c and d).

View larger version (146K): [in a new window]   Figure 1c. Transverse CT scans in 59-year-old man with hemangioma accompanied by AP shunt. (a, b) Consecutive HAP CT scans show small hyperattenuating mass (thick solid arrows in b) in posterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (thin solid arrows in a and b) adjacent to the mass. Branch of right portal vein (open arrow in a and b) in wedge-shaped homogeneously hyperattenuating area shows early enhancement that suggests presence of AP shunt. (c, d) Consecutive PVP CT scans show the still-hyperattenuating mass (thick arrows in d) and the peripheral wedge-shaped hyperattenuating area (thin arrows in c and d).

View larger version (150K): [in a new window]   Figure 1d. Transverse CT scans in 59-year-old man with hemangioma accompanied by AP shunt. (a, b) Consecutive HAP CT scans show small hyperattenuating mass (thick solid arrows in b) in posterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (thin solid arrows in a and b) adjacent to the mass. Branch of right portal vein (open arrow in a and b) in wedge-shaped homogeneously hyperattenuating area shows early enhancement that suggests presence of AP shunt. (c, d) Consecutive PVP CT scans show the still-hyperattenuating mass (thick arrows in d) and the peripheral wedge-shaped hyperattenuating area (thin arrows in c and d).

View larger version (161K): [in a new window]   Figure 2a. Transverse CT scans in 28-year-old man who had undergone left lateral segmentectomy for HCC 18 months previously and was found to have a recurrent HCC accompanied by AP shunt at follow-up CT. (a, b) Consecutive HAP CT scans show small hyperattenuating tumor (solid arrows) in anterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (open arrows) adjacent to the tumor. (c, d) Consecutive PVP CT scans show heterogeneously hypoattenuating tumor (white arrows) and the peripheral wedge-shaped slightly hyperattenuating area (black arrows) adjacent to the tumor.

View larger version (163K): [in a new window]   Figure 2b. Transverse CT scans in 28-year-old man who had undergone left lateral segmentectomy for HCC 18 months previously and was found to have a recurrent HCC accompanied by AP shunt at follow-up CT. (a, b) Consecutive HAP CT scans show small hyperattenuating tumor (solid arrows) in anterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (open arrows) adjacent to the tumor. (c, d) Consecutive PVP CT scans show heterogeneously hypoattenuating tumor (white arrows) and the peripheral wedge-shaped slightly hyperattenuating area (black arrows) adjacent to the tumor.

View larger version (175K): [in a new window]   Figure 2c. Transverse CT scans in 28-year-old man who had undergone left lateral segmentectomy for HCC 18 months previously and was found to have a recurrent HCC accompanied by AP shunt at follow-up CT. (a, b) Consecutive HAP CT scans show small hyperattenuating tumor (solid arrows) in anterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (open arrows) adjacent to the tumor. (c, d) Consecutive PVP CT scans show heterogeneously hypoattenuating tumor (white arrows) and the peripheral wedge-shaped slightly hyperattenuating area (black arrows) adjacent to the tumor.

View larger version (170K): [in a new window]   Figure 2d. Transverse CT scans in 28-year-old man who had undergone left lateral segmentectomy for HCC 18 months previously and was found to have a recurrent HCC accompanied by AP shunt at follow-up CT. (a, b) Consecutive HAP CT scans show small hyperattenuating tumor (solid arrows) in anterior segment of right lobe and peripheral wedge-shaped homogeneously hyperattenuating area (a THAD) (open arrows) adjacent to the tumor. (c, d) Consecutive PVP CT scans show heterogeneously hypoattenuating tumor (white arrows) and the peripheral wedge-shaped slightly hyperattenuating area (black arrows) adjacent to the tumor.