Angiography in Rupture of the Liver

Hepatic Angiography

“…In addition to the confluence of the hepatic arterioles and portal venules at the sinusoidal level, presinusoidal intrahepatic communications exist between the hepatic arterioles and portal venules. These are of two types: (1) direct…”

“…The angiographic findings of hepatoma ( Fig. 6) include: (1) hypervascularity which is the usual finding; rarely hepatomas may be hypovascular; (2) tumor vascularity or neovascularity is typical and is related to the presence of rapidly growing vessels which lack the normal wall components, leading to areas of alternating constriction and dilitation of vessels; (3) arteriovenous shunting to the portal vein may be seen, but not with benign tumors, and it is unusual with liver metastases; arteriovenous shunting is common in advanced cirrhosis; (4) puddling and delayed washout of contrast agent is a rather frequent observation, one that must be differentiated from a similar finding in hemangiomata of the liver; (5) lack of homogeneity of the parenchymal phase of the injection is a frequent but nonspecific finding; (6) intense tumor stain is often seen in the late arterial phase and is typical of a hypervascular lesion; and (7) finally, one may see invasion of a vascular structure by the tumor, creating "encasement" of the vessel or tumor growth into the lumen of the vein producing a tumor thrombus.…”

Aberrant hepatic artery: A potential cause for error in the angiographic diagnosis of traumatic liver hematoma

“…Traumatic h e m a t o m a of the liver may be seen at angiography as an avascular area that displaces hepatic blood vessels and normally opacified hepatic parenchyma [1][2][3][4][5]. A false positive diagnosis may be made in a selective celiac or c o m m o n hepatic arteriogram if the radiologist fails to realize that a seemingly avascular area in the liver is actually normal hepatic parenchyma supplied by an aberrant hepatic artery.…”

“…[1][2][3][4][5]. In addition to intrahepatic and subcapsular hematomas, arteriograms have demonstrated hepatic contusions, hepatic lacerations, arteriovenous fistulas, pseudoaneurysms, traumatic bile cysts, and inferior vena cava obstruction [1][2][3][4][5]. Hematomas are recognized angiographically as avascular masses within the normal hepatic parenchyma.…”