Ouyang Y, Ouyang XH, Yu M, Gu SB. Frequency of arteriovenous shunts in hepatic cavernous hemangiomas in adults as seen on selective arteriography and postembolization radiography.
Cardiovasc Intervent Radiol 2001;
24:161-7. [PMID:
11443403 DOI:
10.1007/s00270-001-0007-9]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE
To study the frequency and angiographic findings of arteriovenous shunts (AVS) associated with adult cavernous hemangiomas of the liver (CHL) on hepatic artery digital subtraction angiography (DSA) and optimize the imaging technique of DSA to improve its diagnostic efficacy.
METHODS
We retrospectively analyzed 43 intraarterial DSA procedures performed on 30 adults with CHL. Of the 30 patients 22 were found to have an AVS. Transcatheter arterial embolization with Lipiodol (L-TAE) was performed on 21 of these and radiographs were taken immediately after embolization to observe the distribution of the injected iodized oil. The results were compared with those of the AVS found on DSA images.
RESULTS
AVS were identified by DSA in 22 (73.3%) of 30 patients. All AVS were located in the peritumoral liver tissue and had a parallel track appearance, or early filling of small draining veins during the arterial phase of DSA. Radiographs taken immediately after L-TAE in 21 of the 22 cases with AVS showed iodized oil filling a few portal branches or draining veins as a result of incompletely occluded shunts in 11 patients. In 10 patients there was complete occlusion and no filling of any vein, or only the originating end of draining veins filled with iodized oil. No evidence of AVS was found in the other eight patients in this series, and in six of these the DSA was not considered diagnostic.
CONCLUSION
The present study indicates that AVS are frequently seen in adults with CHL. DSA with high-quality images is helpful in identifying small AVS of CHL. The formation of an AVS in CHL may be closely related to the pathological changes in the peritumoral liver tissue.
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