Intrahepatic arterioportal shunt

Last revised by Khalid Alhusseiny ◉ on 23 Mar 2025

Citation, DOI, disclosures and article data

Citation:

Abdrabou A, Altadill A, Campos A, et al. Intrahepatic arterioportal shunt. Reference article, Radiopaedia.org (Accessed on 25 Mar 2025) https://doi.org/10.53347/rID-24440

DOI:

https://doi.org/10.53347/rID-24440

Permalink:

https://radiopaedia.org/articles/24440?embed_domain=staging.radpair.com

rID:

24440

Article created:

16 Aug 2013, Ahmed Abdrabou

Disclosures:

At the time the article was created Ahmed Abdrabou had no recorded disclosures.

View Ahmed Abdrabou's current disclosures

Last revised:

23 Mar 2025, Khalid Alhusseiny ◉

Disclosures:

At the time the article was last revised Khalid Alhusseiny had no financial relationships to ineligible companies to disclose.

View Khalid Alhusseiny's current disclosures

Revisions:

18 times, by 14 contributors - see full revision history and disclosures

Systems:

Hepatobiliary

Sections:

Signs

Tags:

liver

Synonyms:

Intrahepatic arterio-portal shunts
Intrahepatic arterio-portal shunting
Intrahepatic arterio-portal fistula
Intrahepatic arterio-portal fistutation
Intrahepatic arterio-portal fistulas
Intrahepatic arterio-portal shunt

Intrahepatic arterioportal shunts, also known as arterioportal fistulas, represent abnormal flow between the portal venous system and a hepatic arterial system within the liver. They can be a reversible cause of portal hypertension.

tumorous shunt
- occurs with hepatocellular carcinoma and to a lesser extent hepatic hemangioma
- transtumoural shunt is due to abnormal communication between the feeding artery and draining vein of the tumor which results in increased vascularity around the tumor manifested as peritumoral transient hepatic attenuation differences (THAD)
- portal vein may show early enhancement in the dynamic arterial scan without enhancement of its main tributaries, the splenic and superior mesenteric veins
non-tumorous shunt
- mainly due to liver biopsy and other hepatic intervention
- may be due to liver cirrhosis itself owing to deformation of hepatic sinusoids which increases arterial pressure or portal vein extrinsic compression that also leads to increased arterial pressure
- congenital intrahepatic arterioportal fistula (rare) ³

Differential diagnosis

Sometimes arterioportal shunts appear in dynamic CT as enhancing nodules, which can mimic hepatocellular carcinoma. The best way to differentiate is by using MRI with SPIO (superparamagnetic iron oxide) which is deposited in hepatocellular carcinoma and washed out in vascular shunt.