J Korean Radiol Soc.  1995 Aug;33(2):259-264.

Intrahepatic Arterioportal Shunt:A Mechanism of Hypovascular Hepatocellular Carcinoma

• Chang JC
• Cho JH

Abstract

PURPOSE
To prove whether the arterioportal shunt, especially transvasal shunt is one of the cause of the hypovascular hepatocellular carcinoma.
MATERIALS AND METHODS
We evaluated the early phase images of table incremental dynamic CT and hepatic angiography in 20 cases of hepatoceltular carcinomas with transvasal arterioportal shunt.
RESULTS
In hepatic arteriography, 18 cases were hypovascular and the remained 2 cases showed hypervascular tumor staining than surrounding normal hepatic parenchyme. In the early phase dynamic CT, 18 cases were hypodense(including 4 cases of focal hyperdensity in hypodense background), one was isodense and remaining one was hyperdense.
CONCLUSION
Arterioportal shunt, especially transvasal shunt may make originally hypervasular hepato-cellular carcinoma to hypovascular lesion in the early phase dynamic CT or hepatic arteriography. In attempt to differentiate hepatic masses by tumor vascularity in recently widely used table incremental dynamic CT, the vascular patterns of the mass should be considered by close evaluation of vascular pattern of the liver, such as morphology of perfusion abnormality and arterioportal shunt, etc.

MeSH Terms

Angiography
Carcinoma, Hepatocellular*
Liver
Perfusion