Multicenteric hepatocellular carcinoma with arteriovenous shunt
Known patient with liver cirrhosis developed dyspnea and chest tightness
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Multiple hepatic focal lesions that display early arterial enhancement followed by rapid washout in portal venous phase. Early filling of the left hepatic vein which appears abnormally dilated suggest A-V fistulous communication. Transient hepatic attenuation difference is also noted at right and left lobes.
Diagnosis Multicentric hepatocellular carcinoma with A-V fistula