Hepatic Capsular and Subcapsular Pathologic Conditions: Demonstration with CT and MR Imaging

Abstract

A variety of pathologic conditions and pseudolesions occur at the capsular and subcapsular regions of the liver and are detected with cross-sectional abdominal imaging. These entities are related to anatomic and hemodynamic characteristics of the liver such as negative subdiaphragmatic pressure, connection with other viscera and extraperitoneal sites by the perihepatic ligaments, and a "third inflow" of blood from sources other than the usual hepatic arterial and portal venous sources. Pathologic conditions can affect the hepatic capsular and subcapsular regions by way of peritoneal, hematogenous, biliary, and perihepatic ligamentous routes. Pseudolesions or benign conditions may also be identified on the basis of altered hemodynamics of the liver. Computed tomography and magnetic resonance imaging with a multiphasic approach can be used to identify and characterize these entities. Familiarity with the wide spectrum of pathologic conditions and pseudolesions at the hepatic capsular and subcapsular regions and precise knowledge of the anatomic and hemodynamic characteristics of the liver will aid the radiologist in diagnosing pathologic conditions and differentiating pseudolesions from true lesions.

Distinct MDCT imaging features to differential diagnosis of hepatic paragonimiasis and small hepatocellular carcinoma

“…In this study, the right liver lobe was most commonly involved, probably due to its close proximity to the duodenum and the migration route of the worm. Besides, the hepatic subcapsular region was the most common site of paragonimiasis as reported by Lee and colleagues [18]. The lesions were initially located mainly in the subcapsular region because the parasites penetrated the intestinal wall and migrated through the peritoneal cavity to the liver after perforating the Glisson capsule.…”

Spontaneous retroperitoneal and subcapsular liver hematoma. The diagnostic contribution of CT, US and CEUS. Case report

“…The development mechanism of subcapsular liver hematomas, as well as their self-limiting character is conditioned by the anatomy of the liver capsule. This is made of two layers: the first is the visceral layer (capsule of Glisson) in close contact with the liver parenchyma, and the second is actually a reflection of the peritoneum sustaining the liver in contact with the diaphragm (hepatodiaphragmatic ligament) [12]. Since the capsule of Glisson is fibrous and has no elasticity, the shape of the hematoma is convex towards the parenchyma, an aspect that helps to distinguish a hematoma from other perihepatic not subcapsular collections, in which the shape of the liver is not modified by compression.…”

Nöroblastomun Karaciğer Kapsülü ve Peritona Nadir Görülen Metastazı

“…The liver capsule and subcapsular area can be affected by various pathologic conditions such as infections (perihepatitis, parasitic diseases), infiltrative (lymphoma, extramedullary hematopoiesis), and metastatic diseases (8). The liver capsule and subcapsular area can be affected by various pathologic conditions such as infections (perihepatitis, parasitic diseases), infiltrative (lymphoma, extramedullary hematopoiesis), and metastatic diseases (8).…”