CT finding of transient focal increased attenuation of the liver adjacent to the gallbladder in acute cholecystitis.

Yamashita, K; Jin, Meyong Jun; Hirose, Yoshinobu; Morikawa, Mitsuhiro; Sumioka, H.; Itoh, Kuniyasu; Konish, J.

doi:10.2214/ajr.164.2.7839966

Cited by 107 publications

(44 citation statements)

References 17 publications

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“…The transient enhancement near the gallbladder in patients with gallbladder disease can also be attributed to the increased blood flow from the dilated aberrant cystic vein of diseased hypervascular gallbladder [85,86]. Hepatic abscesses cause inflammation and hepatic arterial hyperemia in addition to portal venous flow stoppage.…”

Section: Inflammatory Changesmentioning

confidence: 99%

Hepatic abnormalities related to blood flow: evaluation with dual-phase helical CT

et al. 1999

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Dual-phase contrast-enhanced helical computed tomography (CT) has become a popular technique for the detection and characterization of hepatic lesions [1][2][3][4][5][6][7]. In addition to improved detection of small hypervascular lesions, dual-phase helical CT can provide useful information for the differential diagnosis of various liver lesions by showing contrast enhancement features on scans obtained during the hepatic arterial (more precisely, arterial-dominant) phase (HAP) and the portal venous phase (PVP). Furthermore, careful analysis of the patterns of contrast enhancement at both the HAP and PVP of dualphase helical CT is helpful in the evaluation of hepatic hemodynamic alterations [6,7]. Therefore, at many institutions including ours, dual-phase helical CT is routinely performed for the evaluation of all hepatic lesions [5][6][7][8].Hepatic abnormalities related to blood flow include normal vascular anatomic variants; vascular obstructions such as portal venous obstruction, hepatic venous obstruction, hepatic arterial obstruction, and mediastinal or thoracic venous obstruction; focal liver lesions such as arterioportal shunt, hypervascular tumor, and inflammatory processes; and uncertain etiologies [8 -10].The use of helical CT is apparently increasing the chances of encountering these abnormalities in daily practice, and the importance of knowledge of the hemodynamics of hepatic blood flow has been increasing. Thus, familiarity with the helical CT appearances of different types of hepatic abnormalities related to blood flow allows the radiologist to separate clinically insignificant flow phenomena from perfusion disorders caused by underlying parenchymal or vascular disease.In this article, we discuss how hepatic blood flow can affect the appearance of hepatic abnormalities on dualphase helical CT scans. Physiology of hepatic blood flowThe liver has a dual supply of the portal vein and hepatic artery. The hepatic artery delivers about 20 -25% of blood to the liver, whereas the portal vein delivers about 75-80% [8]. These two hepatic vessels have mutual communication systems including transvasal and transplexal routes [10]. Among them, the most prominent route is transplexal via peribiliary plexus.These routes play an important role when hepatic vessels are compromised. Therefore, knowledge of mutual communication systems of hepatic vessels is essential to understand the pathophysiology and hemodynamics of hepatic abnormalities related to blood flow (Fig. 1). Dual-phase helical CT techniquesWith the advent of helical CT technology, it has become possible to image the liver during the HAP and PVP of enhancement after a single bolus infusion of iodinated contrast material. This dual-phase helical technique is ideally suited to imaging the liver, which is unique among abdominal organs by virtue of its dual blood supply [5,7]. Helical CT images are obtained during a 20 -30-s breath-holding. Scan parameters are collimation, 5-10 mm; pitch, 1-1.5; 120 -140 kV; 150 -290 mA; and rotation time, 0.75-1 s. Images...

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Section: Inflammatory Changesmentioning

confidence: 99%

Hepatic abnormalities related to blood flow: evaluation with dual-phase helical CT

et al. 1999

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“…Yamashita et al [26] also reported that transient focal increased attenuation of the liver may occur on CT scans in patients with acute cholecystitis. This increased attenuation associated with acute cholecystitis has a typical location and pattern, and is probably attributed to hepatic arterial hyperemia and early venous drainage from the adjacent inflamed gallbladder.…”

Section: ) Pseudolesion In the Drainage Area Of Parabiliary Venous Smentioning

confidence: 96%

Radiologic manifestation of hepatic pseudolesions and pseudotumors in the third inflow area

Kobayashi¹,

Gabata²,

Matsui³

2010

Imaging in Medicine

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SummaryWe sometimes encounter hepatic pseudolesions and pseudotumors of the third inflow area on imaging. Generally, to differentiate these lesions of true hepatic neoplasm on radiological examinations are easy with the knowledge of common site in the liver and characteristic findings of these lesions. However, it occasionally mimic hepatocellular carcinoma in various imaging modalities. In this article, we are going to provide current knowledge about pseudolesions and pseudotumors in the third inflow area on imaging.To have knowledge about pseudolesions and pseudotumors in the third inflow area can aid in correct diagnosis and avoid unnecessary treatment.

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“…(6,7) Characteristically, there is an enhancement rim in the adjacent liver. (8) Classically, a calculus can be seen impacted in the gallbladder neck or cystic duct (Fig. 2).…”

Section: Ct Of Acute Cholecystitis and Associated Complicationsmentioning

confidence: 99%

Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting

Chawla

Bosco

Lim

et al. 2015

smedj

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CT finding of transient focal increased attenuation of the liver adjacent to the gallbladder in acute cholecystitis.

Cited by 107 publications

References 17 publications

Hepatic abnormalities related to blood flow: evaluation with dual-phase helical CT

Hepatic abnormalities related to blood flow: evaluation with dual-phase helical CT

Radiologic manifestation of hepatic pseudolesions and pseudotumors in the third inflow area

Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting

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