Citation, DOI, disclosures and article data
Citation:
Khader.O.Thabet M, Elfeky M, Knipe H, et al. Hepatic pseudolesion near falciform ligament. Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://doi.org/10.53347/rID-32999
Hepatic pseudolesions near the falciform ligament show abnormal attenuation without mass effect. They may be seen on contrast-enhanced CT scans as either a region of high or low attenuation relative to the rest of the liver. They are typically located in the medial segment of the left lobe of the liver near the falciform ligament. Equivalent features have also been described on MRI and nuclear scintigraphy 4.
Epidemiology
They may be present in up to 20% of portal venous phase CT scans 7,9.
Pathology
It is thought to be due to variation in venous drainage. This region is usually drained by the superior vein of Sappey to the superior epigastric vein, then into the internal thoracic vein, and finally to the superior vena cava (SVC).
Some of these lesions result from focal fatty sparing or infiltration.
In the case of SVC obstruction, these veins will dilate as a collateral pathway and the pseudolesion will show increased enhancement (hepatic hot spot sign).
Location
medial left liver adjacent to falciform ligament (segment 4): ~92%
both sides of falciform ligament: ~1.5%
adjacent to porta hepatis: ~3%
adjacent to gallbladder: ~3% 6
Shape
triangular shape: ~66%
ovoid: ~19%
nodular: ~15%
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7. Genchellac H, Yilmaz S, Ucar A et-al. Hepatic pseudolesion around the falciform ligament: prevalence, aberrant venous supply, and fatty infiltration evaluated by multidetector computed tomography and magnetic resonance imaging. J Comput Assist Tomogr. 2007;31 (4): 526-33. doi:10.1097/01.rct.0000284387.68449.ec - Pubmed citation
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8. Ohashi I, Ina H, Gomi N et-al. Hepatic pseudolesion in the left lobe around the falciform ligament at helical CT. Radiology. 1995;196 (1): 245-9. doi:10.1148/radiology.196.1.7784576 - Pubmed citation
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9. Ucar A, Sahin D, Bulakci M et-al. Prevalence of hepatic pseudolesions around the falciform ligament in a paediatric population. J. Int. Med. Res. 2012;39 (4): 1490-6. Pubmed citation
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