Intrahepatic arterioportal shunt

Last revised by Arlene Campos on 13 Dec 2023

Citation, DOI, disclosures and article data

Citation:

Abdrabou A, Campos A, Weerakkody Y, et al. Intrahepatic arterioportal shunt. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-24440

DOI:

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

Permalink:

https://radiopaedia.org/articles/24440

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:

13 Dec 2023, Arlene Campos ◉

Disclosures:

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

View Arlene Campos's current disclosures

Revisions:

16 times, by 12 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 haemangioma
- transtumoural shunt is due to abnormal communication between the feeding artery and draining vein of the tumour which results in increased vascularity around the tumour 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.

References

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