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Assessment of the Hepatic Vessels with MDCT

  • Rocio Perez-Johnston
  • Dipti K. Lenhart
  • Daniella F. Pinho
  • Dushyant V. Sahani
Part of the Medical Radiology book series (MEDRAD)

Abstract

Multidetector computed tomography angiography (MDCTA) is an established, noninvasive and effective imaging method to evaluate the liver primarily for neoplasm staging and presurgical planning. However, its role has also extended into variety of other clinical indications. Technological advances in MDCT scanners and post processing now offer new opportunities with CTA but the challenges of protocol optimization should be confronted. In this article, we will focus on the technical details with MDCTA protocols for the liver and discuss the common pathologic conditions where CTA is now considered integral to patient management.

Keywords

Portal Vein Hepatic Artery Inferior Vena Cava Hepatic Vein Arterial Phase 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Allen PJ, Nissan A, Picon AI et al (2005) Technical complications and durability of hepatic artery infusion pumps for unresectable colorectal liver metastases: an institutional experience of 544 consecutive cases. J Am Coll Surg 201(1):57–65PubMedCrossRefGoogle Scholar
  2. Befeler AS, Hayashi PH, Bisceglie AM (2005) Liver transplantation for hepatocellular carcinoma. Gatroenterology 128:1752–1764CrossRefGoogle Scholar
  3. Brancatelli G, Federle MP, Grazioli L et al (2002a) Hepatocellular carcinoma in noncirrhotic liver: CT, clinical, and pathologic findings in 39 US residents. Radiology 222:89–94PubMedCrossRefGoogle Scholar
  4. Brancatelli G, Federle MP, Grazioli L et al (2002b) Large regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinico-pathologic correlation. Am J Roentgenol 178:877–883Google Scholar
  5. Buyse M (1996) Reappraisal of hepatic arterial infusion in the treatment of nonresectable liver metastases from colorectal cancer: Meta-Analysis Group in Cancer. J Natl Cancer Inst 88:252–258CrossRefGoogle Scholar
  6. Cady B, Jenkins RL, Steele GD, Lewis D et al (1998) Surgical Margin in Hepatic resection for colorectal metastasis. Ann Surg 227:566–571PubMedCrossRefGoogle Scholar
  7. Catalano O, Singh A, Uppot R et al (2008) Vascular and biliary variants in the liver: implications for liver surgery. Radiographics 28:359–378PubMedCrossRefGoogle Scholar
  8. Choen J, Edelman RR, Chopra S (1992) Portal vein thrombosis: a review. Am J Med 92:173–182CrossRefGoogle Scholar
  9. Chopra S, Dodd GD 3rd, Chintapalli KN et al (2000) Transjugular intrahepatic portosystemic shunt: accuracy of helical CT angiography in the detection of shunt abnormalities. Radiology 215:115–122PubMedGoogle Scholar
  10. De Gaetano AM, Lafotune M, Patriquin H et al (1995) Cavernous transformation of the portal vein: patterns of intrahepatic and splachnic collateral circulation detected with Doppler Sonography. Am J Roentgenol 165:1151–1155Google Scholar
  11. Denninger MH, Chait Y, Casadevall N et al (2000) Causes of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors. Hepatology 31:587–591PubMedCrossRefGoogle Scholar
  12. Frenchel S, Boll DT, Fleiter TR et al (2003) Multislice helical CT of the pancreas and spleen. Eur J Radiol 45(suppl 1):S59–S72CrossRefGoogle Scholar
  13. Glockner JF, Forauer AR (1999) Vascular or ischemic complications after liver transplantation. AJR 173:1055–1059PubMedGoogle Scholar
  14. Gore RM, Mathieu DG, White EM et al (1994) Passive hepatic congestion: cross-sectional imaging features. Am J Roentgenol 162:71–75Google Scholar
  15. Horton KM, Fishman EK (2000) 3D CT angiography of the celiac and superior mesenteric arteries with multidetector CT data sets: preliminary observations. Abdom Imaging 25:523–525PubMedCrossRefGoogle Scholar
  16. Iannaccone R, Laghi A, Catalano C et al (2005) Hepatocellular carcinoma: role of unenhanced and delayed phase multi-detector row helical CT in patients with cirrhosis. Radiology 234:460–467PubMedCrossRefGoogle Scholar
  17. Ikai I, Arii S, Kojiro M et al (2004) Reevaluation of prognostic factors for survival after liver resection in patients with hepatocellular carcinoma in a Japanese nationwide survey. Cancer 101:769–802CrossRefGoogle Scholar
  18. Kamel IR, Liapi E, Fishman EK (2005) Liver and biliary system: evaluation by multidetector CT. Radiol Clin N Am 43:977–997PubMedCrossRefGoogle Scholar
  19. Katyal S, Oliver JH, Buck DG, Federle MP (2000) Detection of vascular complications after liver transplantation: early experience in multislice CT angiography volume rendering. Am J Roentgenol 175:1735–1739Google Scholar
  20. Kim TK, Chung JW, Han JK et al (1999) Hepatic changes in benign obstruction of the hepatic inferior vena cava: CT findings. Am J Roentgenol 173:1235–1242Google Scholar
  21. Kim SY, Kim KW, Kim MJ, Shin YM et al (2007) Multidetector row CT of various hepatic artery complications after living donor liver transplantation. Abdom Imaging 32:635–643PubMedCrossRefGoogle Scholar
  22. Lane MJ, Jeffrey RB Jr, Katz DS (2000) Spontaneous intrahepatic vascular shunts. Am J Roentgenol 174:125–131Google Scholar
  23. Legmann P, Costes V, Tudoret L et al (1995) Hepatic artery thrombosis after liver transplantation: diagnosis with spiral CT. AJR Am J Roentgenol 164:97–101PubMedGoogle Scholar
  24. Lim JH, Kim CK, Lee WJ et al (2000) Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic livers: accuracy of helical CT in transplant patients. Am J Roentgenol 175:693–698Google Scholar
  25. Lo CM, Fan ST, Liu CL et al (1997) Adult-to-adult donor liver transplantation using extended right lobe grafts. Ann Surg 226:261–269PubMedCrossRefGoogle Scholar
  26. Lv P, Lin XZ, Li J, Li W, Chen K (2011) Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method. Radiology 259(3):720–729PubMedCrossRefGoogle Scholar
  27. Mancuso A, Fung K, Mela M et al (2003) TIPS for acute and chronic Budd-Chiari syndrome: a single center experience. J Hepatol 38:751–754PubMedCrossRefGoogle Scholar
  28. Marin D, Nelson RC, Samei E et al (2009) Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection—initial clinical experience. Radiology 251(3):771–779PubMedCrossRefGoogle Scholar
  29. Mazzaferro V, Regalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334(11):693–699Google Scholar
  30. Moulton JS, Miller BL, Dodd GD III, Vu DN (1988) Passive hepatic congestion in heart failure: CT abnormalities. Am J Roentgenol 151:939–942Google Scholar
  31. Murakami T, Kim T, Takamura M et al (2001) Hypervascular hepatocellular carcinomas: detection with double arterial phase multi-row helical CT. Radiology 218:763–767PubMedGoogle Scholar
  32. Nakayama Y, Awai K, Funama Y, Hatemura M, Imuta M, Nakaura T, Ryu D et al (2005) Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise (No. 3). Radiology 237:945–951Google Scholar
  33. Pannu HK, Maley WR, Fishman EK (2001) Liver transplantation: preoperative CT. Radiographics 21:S133–S146PubMedGoogle Scholar
  34. Parvey R, Raval B, Sandler C (1994) Portal vein thrombosis: imaging findings. Am J Roentgenol 162:77–81Google Scholar
  35. Pasha SF, Gloviczki P, Stanson AW et al (2007) Splanchnic artery aneurysms. Mayo Clin Proc 82(4):472–479PubMedCrossRefGoogle Scholar
  36. Platt JF, Yutzy GG, Bude RO, Ellis JH, Rubin JM (1997) Use of Doppler sonography for revealing hepatic artery stenosis in liver transplant recipients. AJR 168:473–476PubMedGoogle Scholar
  37. Quiroga S, Sebastia C, Pallisa E et al (2001) Improved diagnosis of hepatic perfusion disorders: value of hepatic arterial phase imaging during helical CT. Radiographics 21:65–81PubMedGoogle Scholar
  38. Rossi M, Rebonato A, Greco L et al (2008) Endovascular exclusion of visceral artery aneurysms with stent-grafts: technique and long-term follow-up. Cardiovasc Intervent Radiol 31(1):36–42PubMedCrossRefGoogle Scholar
  39. Sahani D, Mehta A, Blake M et al (2004) Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery. Radiographics 24:1367–1380PubMedCrossRefGoogle Scholar
  40. Shah Z, McKernan MG, Hahn P, Sahani D (2007) Enhancing and expansile portal vein thrombosis value in the diagnosis of hepatocellular carcinoma in patients with multiple hepatic lesions. Am J Roentgenol 188:1320–1323CrossRefGoogle Scholar
  41. Shanley CJ, Shah NL, Messina LM (1996) Common splanchnic artery aneurysms: splenic, hepatic and celiac. Ann Vasc Surg 10(3):315–322PubMedCrossRefGoogle Scholar
  42. Stange B, Settmacher U, Glanemann M et al (2000) Aneurysms of the hepatic artery after liver transplantation. Transplant Proc 32:533–534PubMedCrossRefGoogle Scholar
  43. Suzuki K, Epstein ML, Kohlbrenner R et al (2011) Automated CT liver volumetry compared with interactive volumetry and manual volumetry. AJR 197:W706–W712PubMedCrossRefGoogle Scholar
  44. Tajima T, Honda H, Taguchi K et al (2002) Sequential hemodynamic change in hepatocellular carcinoma and dysplastic nodules: CT angiography and pathologic correlation. Am J Roentgenol 178:885–897Google Scholar
  45. Tanikake M, Shimizu T, Narabayashi I et al (2003) Three-dimensional angiography of the hepatic artery: use of multi-detector row helical CT and contrast agent. Radiology 227:883–889PubMedCrossRefGoogle Scholar
  46. Tatsugami F, Matsuki M, Kani H et al (2006) Effect of saline pushing after contrast material injection in abdominal multidetector computed tomography with the use of different iodine concentrations. Acta Radiol 47(2):192–197PubMedCrossRefGoogle Scholar
  47. Thomas A, Bernhard M (2005) New trends in multidetector computed tomography angiography of peripheral arteries. Advances in MDCT—an international literature review service 2(2):1–6Google Scholar
  48. Torabi M, Hosseinzadeh K, Federle M (2008) CT of nonneoplastic hepatic vascular and perfusion disorders. Radiographics 28:1967–1982PubMedCrossRefGoogle Scholar
  49. Tublin M, Dodd GD, Baron R (1997) Benign and malignant portal vein thrombosis: differentiation by CT characteristics. Am J Roentgenol 168:719–723Google Scholar
  50. Tzakis AG, Gordon RD, Shaw BW Jr, Iwatsuki S, Starzl TE (1985) Clinical presentation of hepatic artery thrombosis after liver transplantation in the cyclosporine era. Transplantation 40:667–671PubMedCrossRefGoogle Scholar
  51. United Network for Organ Sharing (UNOS). Policy 3.6.4.4. Allocation of livers: liver transplant candidates with hepatocellular carcinoma.http://optn.transplant.hrsa.gov/PoliciesandBylaws2/policies/pdfs/policy_8.pdf. Accessed 8 Mar 2011
  52. Valla DC (2003) The diagnosis and management of the Budd-Chiari syndrome: consensus and controversies. Hepatology 38:793–803PubMedGoogle Scholar
  53. Wagner S, Adson MA, van Heerden JA et al (1984) The natural history of hepatic metastases from colorectal cancer. Ann Surg 199:502–507PubMedCrossRefGoogle Scholar
  54. Yao FY, Ferrell L, Bass NM et al (2001) Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology 33:1394–1403PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Rocio Perez-Johnston
    • 1
  • Dipti K. Lenhart
    • 1
  • Daniella F. Pinho
    • 1
  • Dushyant V. Sahani
    • 1
  1. 1.Division of Abdominal Imaging and Intervention, Radiology, Harvard Medical SchoolMassachusetts General HospitalBostonUSA

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