PMC6159114_01
Abdominal ultrasound revealed a normal-sized liver, with a diffusely heterogeneous echostructure suggesting chronic liver disease (a and b). On CT (c and d) the liver is slightly dysmorphic. There is a nodular liver lesion in the right lobe, with CT enhancement pattern in the arterial (c) and portal (d) phases suggesting a benign vascular shunt (arrow in b), which is stable on comparing with multiple previous examinations (not shown).
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Abdominal ultrasonography revealed a diffuse heterogenic echostructure in the liver (Figure 1a, b).
Contrast-enhanced abdominal CT scan. Coronal images showed the presence of an abnormal short portal vein, with a systemic drainage in the inferior cava vein (a), and the superior mesenteric vein and splenic vein draining in the abnormal portal vein (b and c), as depicted by the arrows.
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Abdominal CT showed the presence of an abnormal short portal vein, with systemic drainage into the inferior cava vein below the liver, and the superior mesenteric vein and splenic vein draining into the abnormal portal vein (Figure 2) (video 1).
Multiplanar curved reformatted CT images better depicted the short abnormal portal vein draining in the inferior vena cava (a and b).
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The venous phase and multiplanar curve reformatted images better depicted this short, dilated shunt vessel (abnormal portal vein) after the confluence of the superior mesenteric vein and splenic vein, and the inferior vena cava (Figure 3).
Axial CT images acquired during the arterial phase show a dilated (circle in a) and tortuous hepatic artery (arrows in b).
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Furthermore, a dilated and tortuous hepatic artery was also detected (Figure 4) (video 2).
MR images show the presence of the shunt with the inferior vena cava (arrows in b), and abnormal portal vein (circle in a).
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MRI shows the presence of the shunt with similar findings (Figure 5) (video 3).