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Prevalence, Characteristics, and Fate of Intrahepatic Nontumorous Arterioportal Shunts on MRI in Patients With Hepatic Steatosis

Wehrli, Natasha E. MD; Mussi, Thais C. MD; Rosenkrantz, Andrew B. MD

Journal of Computer Assisted Tomography: July/August 2012 - Volume 36 - Issue 4 - p 375–380
doi: 10.1097/RCT.0b013e31825a28be
Abdominal Imaging

Objective To assess the frequency, characteristics, and fate of arterioportal shunts in patients with hepatic steatosis and to compare this to the frequency in patients without liver disease.

Methods Eighty-four patients with hepatic steatosis but no other known liver disease and who underwent 2 abdominal magnetic resonance imaging (MRI) examinations at least 1 year apart formed one study cohort. Eighty-four subjects without steatosis or other known liver disease and who also underwent 2 MRI examinations at least 1 year apart formed a control group. Two radiologists evaluated the initial study for the presence and characteristics of arterial enhancing foci not visible on other sequences and assessed the fate of these foci on the follow-up study.

Results Of the patients with steatosis, 36.9% (95% confidence interval [CI], 26.6%–48.1%) demonstrated a total of 108 arterial enhancing foci, compared with 20 arterial enhancing foci in 13.1% of controls (95% CI, 6.7%–22.2%). Both the number of subjects with at least one arterial enhancing focus and the mean number per subject were significantly greater in the steatosis cohort (P < 0.001). The arterial enhancing foci were generally small and peripheral in location in both cohorts. On follow-up examination, all lesions disappeared, decreased in size, were stable, or increased slightly in size while remaining inconspicuous on other sequences.

Conclusion Findings consistent with arterioportal shunts were observed at an unexpectedly high frequency in the control group but at a significantly greater frequency in the steatosis group. All foci exhibited benign behavior on long-term follow-up. Future studies may assess for clinical implications of this finding in patients with hepatic steatosis.

From the *Department of Radiology, NYU Langone Medical Center, New York, NY; and †Hospital Israelita Albert Einstein, Sao Paulo-SP, Brazil.

Received for publication December 23, 2011; accepted April 11, 2012.

Reprints: Andrew B. Rosenkrantz, MD, Department of Radiology, NYU Langone Medical Center, 560 First Ave, TCH-HW202, New York, NY 10016 (e-mail: Andrew.Rosenkrantz@nyumc.org).

The authors report no conflicts of interest.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.