Frequency of Arteriovenous Shunts in Hepatic Cavernous Hemangiomas in Adults as Seen on Selective Arteriography and Postembolization Radiography |
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Authors: | Yong Ouyang Xue-Hui Ouyang Ming Yu Shu-Bin Gu |
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Institution: | (1) Department of Interventional Radiology, Inner Mongolia Autonomous Region's Hospital, Huhehaote 010017, China, CN |
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Abstract: | Purpose: To study the frequency and angiographic findings of arteriovenous shunts (AVS) associated with adult cavernous hemangiomas
of the liver (CHL) on hepatic artery digital subtraction angiography (DSA) and optimize the imaging technique of DSA to improve
its diagnostic efficacy.
Methods: We retrospectively analyzed 43 intraarterial DSA procedures performed on 30 adults with CHL. Of the 30 patients 22 were found
to have an AVS. Transcatheter arterial embolization with Lipiodol (L-TAE) was performed on 21 of these and radiographs were
taken immediately after embolization to observe the distribution of the injected iodized oil. The results were compared with
those of the AVS found on DSA images.
Results: AVS were identified by DSA in 22 (73.3%) of 30 patients. All AVS were located in the peritumoral liver tissue and had a parallel
track appearance, or early filling of small draining veins during the arterial phase of DSA. Radiographs taken immediately
after L-TAE in 21 of the 22 cases with AVS showed iodized oil filling a few portal branches or draining veins as a result
of incompletely occluded shunts in 11 patients. In 10 patients there was complete occlusion and no filling of any vein, or
only the originating end of draining veins filled with iodized oil. No evidence of AVS was found in the other eight patients
in this series, and in six of these the DSA was not considered diagnostic.
Conclusion: The present study indicates that AVS are frequently seen in adults with CHL. DSA with high-quality images is helpful in identifying
small AVS of CHL. The formation of an AVS in CHL may be closely related to the pathological changes in the peritumoral liver
tissue. |
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Keywords: | : Hemangioma— Cavernous— Liver neoplasms— Arteriovenous shunts— Digital subtraction angiography |
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