EURORAD ESR

Case 16034

Contrast enhanced Ultrasound (CEUS) of a post-trans-jugular liver biopsy hepatic artery pseudoaneuyrsm in a transplant liver.

Author(s)
Leenknegt B, Zebari S, Rufai O, Kibriya N, Sidhu PS.

Department of Radiology, King's College Hospital, Denmark Hill, London, United Kingdom. Email: benjamin.leenknegt@ugent.be
 
Patient
female, 34 year(s)
 
 
  • Figure 1
    B-mode ultrasound

    A longitudinal view through the right lobe of the liver, depicting the hepatic artery (short arrow), the portal vein (star) and a low reflective area of indeterminate nature on the B-mode ultrasound (long arrow).

     
    Area of Interest: Liver; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Cysts;
     
     
  • Figure 2
    Colour Doppler ultrasound

    A longitudinal view with colour Doppler, demonstrating the hepatic artery pseudoaneurysm (long arrow) with the ‘ying yang’ sign of flow reversal, depicted. The hepatic artery is also seen (short arrow).

     
    Area of Interest: Liver; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Aneurysms;
     
     
  • Figure 3
    Contrast-enhanced ultrasound

    A longitudinal view using CEUS, during the late arterial phase, depicting the tortious hepatic artery (long arrow), the enhancement of the pseudoaneurysm (star) and the early filling of the hepatic vein (short arrow).

     
    Area of Interest: Liver; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Aneurysms;
     
     
  • Figure 4
    Contrast-enhanced ultrasound

    A longitudinal view in the portal venous phase of the CEUS examination, depicting the continuing enhancement of the pseudoaneurysm (star), and prominent enhancement of the draining hepatic vein (short arrow).

     
    Area of Interest: Liver; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Aneurysms;
     
     
  • Figure 5
    CT
     

    A coronal image from the arterial phase of the CT examination. A bilobulated pseudoaneurysm is demonstrated (arrow).

     
    Area of Interest: Liver; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Aneurysms;

    A coronal image from the portal-venous phase of the CT examination. A bilobulated pseudoaneurysm is demonstrated (arrow).

     
    Area of Interest: Liver; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Aneurysms;
     
     
  • Figure 6
    Angiography

    The catheter is positioned selectively within the main hepatic artery, with depiction of the tortuous right hepatic artery (long arrow), feeding the pseudoaneurysm (star) and the early draining hepatic vein (short...

     
    Area of Interest: Liver; Imaging Technique: Catheter arteriography; Procedure: Diagnostic procedure; Special Focus: Aneurysms;
     
     
A longitudinal view through the right lobe of the liver, depicting the hepatic artery (short arrow), the portal vein (star) and a low reflective area of indeterminate nature on the B-mode ultrasound (long arrow).
 
A longitudinal view with colour Doppler, demonstrating the hepatic artery pseudoaneurysm (long arrow) with the ‘ying yang’ sign of flow reversal, depicted. The hepatic artery is also seen (short arrow).
 
A longitudinal view using CEUS, during the late arterial phase, depicting the tortious hepatic artery (long arrow), the enhancement of the pseudoaneurysm (star) and the early filling of the hepatic vein (short arrow).
 
A longitudinal view in the portal venous phase of the CEUS examination, depicting the continuing enhancement of the pseudoaneurysm (star), and prominent enhancement of the draining hepatic vein (short arrow).
 
A coronal image from the arterial phase of the CT examination. A bilobulated pseudoaneurysm is demonstrated (arrow).
 
A coronal image from the portal-venous phase of the CT examination. A bilobulated pseudoaneurysm is demonstrated (arrow).
 
The catheter is positioned selectively within the main hepatic artery, with depiction of the tortuous right hepatic artery (long arrow), feeding the pseudoaneurysm (star) and the early draining hepatic vein (short arrow).
 
 
 
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