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Abnormal Intrahepatic Vascular Shunt: rule of high sensitive color doppler and contrast harmonic imaging
ARTEROPORTAL SHUNT (case 2)
Cadence Coherent Contrast Imaging (low mechanical index
= 0.2) and SonoVue (Bracco): we can evaluate, in real time, an early enhancement
of the hepatic lesion; the arterial and the portal vessels are seen.
![[click to see clip]](../edu/aiv-shunt/clip_c2_2.jpg) |
[click to see clip] |
At 42 seconds an overlapping of harmonic information comes
from the sinusoidal, arterial and venous vascular bed.
A.D.I. with high mechanical index, allows micro bubbles destruction visualising
the arterial and portal major vessels. In the re-perfusion time we can evaluate
the enhancement before of the arterial vessel and then of the adjacent portion
of portal branch. An intra-lesional fistula can be picked up.
The diagnosis was of high flow haemangioma associated with artery – portal
fistula.
![[click to see clip]](../edu/aiv-shunt/clip_c2_3.jpg) |
[click to see clip] |