Hepatic abnormalities include enlarged hepatic arteries, hepatic artery aneurysms, telangiectasia and arteriovenous fistulae. Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder. In the arterial phase, the liver shows a heterogeneous mosaic-like perfusion pattern due to multiple arteriovenous shunts that show different attenuations and telangiectasias.
Telangiectasias are rounded hypervascular nodules more frequent in the periphery. The vascular supply of the bile ducts depends on the branches of the hepatic artery, so shunts by subtracting the arterial flow can cause ischemic cholangitis. The bile ducts dilatation it may also due to the compression of enlarged vascular structures.

Case courtesy: Dr. Luca Giampaolo