Nutmeg liver
Last revised by Tristan Skalina on 29 Dec 2022
Citation, DOI, disclosures and article data
Citation:
D'Souza D, Skalina T, Weerakkody Y, et al. Nutmeg liver. Reference article, Radiopaedia.org (Accessed on 05 Jun 2023) https://doi.org/10.53347/rID-1746
Permalink:
rID:
1746
Article created:
2 May 2008, Donna D'Souza
Disclosures:
At the time the article was created Donna D'Souza had no recorded disclosures.
View Donna D'Souza's current disclosuresLast revised:
29 Dec 2022, Tristan Skalina
Disclosures:
At the time the article was last revised Tristan Skalina had no recorded disclosures.
View Tristan Skalina's current disclosuresRevisions:
25 times, by 13 contributors - see full revision history and disclosures
Systems:
Sections:
Tags:
Synonyms:
- Nutmeg type liver
- Nutmeg hepatic appearance
A nutmeg liver appearance is due to a perfusion abnormality of the liver usually as result of hepatic venous congestion. When hepatic veins are congested, contrast is prevented from diffusing through the liver in a normal manner. This results in a mottled pattern of contrast enhancement in the arterial and early portal venous phases with decreased enhancement of the liver periphery. The areas of decreased enhancement represent decreased portal flow, hepatic congestion and ischemia. On delayed images parenchymal enhancement becomes more uniform.
Conditions associated with hepatic venous congestion include:
Budd-Chiari syndrome (the caudate lobe may enhance normally as it has a separate draining vein directly into the IVC)
References
- 1. Reuther WL, Newman CA, Smith RE et-al. Gastrointestinal case of the day. Primary leiomyosarcoma of the IVC with Budd-Chiari syndrome. Radiographics. 19 (1): 248-51. Radiographics (full text) - Pubmed citation
- 2. Dähnert W. Radiology review manual. Lippincott Williams & Wilkins. (2003) ISBN:0781738954. Read it at Google Books - Find it at Amazon
- 3. Hilscher M & Sanchez W. Congestive Hepatopathy. Clinical Liver Disease. 2016;8(3):68-71. doi:10.1002/cld.573 - Pubmed
Related articles: Pathology: Hepato-Pancreato-Biliary
- liver
- depositional disorders
- infection and inflammation
- liver abscess
- hepatic hydatid infection
- cirrhosis
- hepatitis
- cholecystitis
- cholangitis
- malignancy
- liver and intrahepatic bile duct tumors
- benign epithelial tumors
- hepatocellular hyperplasia
- hepatocellular adenoma
- hepatic/biliary cysts
- benign nonepithelial tumors
- primary malignant epithelial tumors
- hepatocellular carcinoma
- hepatocellular carcinoma variants
-
cholangiocarcinoma
- intra-hepatic
- mass-forming type
- periductal infiltrating type - Klatskin tumors
- intraductal growing type
- extra-hepatic/large duct type
- intra-hepatic
- biliary cystadenocarcinoma
- combined hepatocellular and cholangiocarcinoma
- hepatoblastoma
- undifferentiated carcinoma
- primary malignant nonepithelial tumors
- hematopoietic and lymphoid tumors
- primary hepatic lymphoma
- hepatic myeloid sarcoma (hepatic chloroma)
- secondary tumors
- miscellaneous
- adrenal rest tumors
- hepatic carcinosarcoma
- hepatic fibroma
- hepatic hemangioma
- hepatic Kaposi sarcoma
- hepatic lipoma
- hepatic mesenchymal hamartoma
- hepatic myxoma
- hepatic rhabdoid tumor
- hepatic solitary fibrous tumor
- hepatic teratoma
- hepatic yolk sac tumor
- inflammatory myofibroblastic tumor (inflammatory pseudotumor)
- nodular regenerative hyperplasia
- pancreatic rest tumors
- primary hepatic carcinoid
- benign epithelial tumors
- liver and intrahepatic bile duct tumors
- metabolic
- trauma
-
vascular and perfusion disorders
- portal vein related
- hepatic artery related
- hepatic veins related
- inferior vena cava related
- other
- third inflow
- liver thrombotic angiitis
- infra diaphragmatic total anomalous pulmonary venous return (TAPVR)
- hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease)
- pancreas
-
pancreatic neoplasms
- cystic neoplasm (cystic pancreatic mass differential diagnosis)
- solid neoplasm
- non-epithelial pancreatic neoplasms
- others
- simple pancreatic cyst
-
pancreatitis (mnemonic for the causes)
- acute pancreatitis
- chronic pancreatitis
- Ascaris-induced pancreatitis
- tropical pancreatitis
- autoimmune pancreatitis
- emphysematous pancreatitis
- hypertriglyceridemia-induced pancreatitis
- hereditary pancreatitis
- pancreatitis associated with cystic fibrosis
- pancreaticopleural fistula
- segmental pancreatitis
- pancreatic atrophy
- pancreatic lipomatosis
- pancreatic trauma
- pancreatic transplant
-
pancreatic neoplasms
- gallbladder and biliary
- congenital malformations and anatomical variants
- gallstones
- gallbladder inflammation
- bile ducts inflammation
- gallbladder wall abnormalities
- other gallbladder abnormalities
- bile duct dilatation (differential)
- bile duct wall thickening (differential)
- bile ducts neoplasms
Unable to process the form. Check for errors and try again.