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Case report
Submitted: 2023-07-12
Accepted: 2023-08-28
Published online: 2023-09-07
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Transient hepatic attenuation difference (THAD) or fat sparing? Aberrant right gastric vein (ARGV) determining a pseudolesion at the border of the IInd/IIIrd liver segments. Review of developmental concepts

Dan Alexandru Arhire12, Marius Constantin Moraru3, Razvan Maxim3, Claudia Cristina Tarniceriu3, Simona Alice Partene Vicoleanu3, Anca Haisan45, Irina Nedelcu6, Alin Horatiu Nedelcu73
·
Pubmed: 37691513
Affiliations
  1. Radiology Clinic, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
  2. Arhimed Radiology, Hatman Sendrea No. 2, Iasi, Romania
  3. Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
  4. Emergency Department, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
  5. Department of Emergency Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
  6. ENT Department, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
  7. Radiology Clinic, Recovery Hospital, Iasi, Romania

open access

Ahead of Print
CASE REPORTS
Submitted: 2023-07-12
Accepted: 2023-08-28
Published online: 2023-09-07

Abstract

The aberrant right gastric vein (ARGV) is a rare anatomical variation. It can be responsible for unexplained hyperdensities in the hepatic parenchyma on CT scans, also known as third inflow effects.

We present two cases sharing similar vascular pattern and slightly different imagistic findings on ultrasound and computer-tomography performed studies.

Both ultrasonographies showed a nodular-geographic hypoechoic area within a hyperechogenic fatty liver. Further CT evaluation showed in both cases a hyperattenuating homogenous area clearly visible on all four phases at the border of the IInd/IIIrd hepatic segment, that enhance especially on the portal venous phase, with no slow-fill, wash-out, central scar or rim-like features. The areas were considered to be focal fat sparing areas in diffuse fatty liver or a perfusion disorder due to the presence of an aberrant right gastric vein.

The aim of this paper is to discuss the embryological aspects which are the groundwork for this vascular anomaly and to correlate the findings with imagistic aspects.

These two ARGV produced pseudolesions, understood as focal fat sparing areas within diffuse fatty livers. These pseudolesions mimic liver tumours, therefore it is important to look for such an aberrant vessel in order to rule out other diagnoses.

Abstract

The aberrant right gastric vein (ARGV) is a rare anatomical variation. It can be responsible for unexplained hyperdensities in the hepatic parenchyma on CT scans, also known as third inflow effects.

We present two cases sharing similar vascular pattern and slightly different imagistic findings on ultrasound and computer-tomography performed studies.

Both ultrasonographies showed a nodular-geographic hypoechoic area within a hyperechogenic fatty liver. Further CT evaluation showed in both cases a hyperattenuating homogenous area clearly visible on all four phases at the border of the IInd/IIIrd hepatic segment, that enhance especially on the portal venous phase, with no slow-fill, wash-out, central scar or rim-like features. The areas were considered to be focal fat sparing areas in diffuse fatty liver or a perfusion disorder due to the presence of an aberrant right gastric vein.

The aim of this paper is to discuss the embryological aspects which are the groundwork for this vascular anomaly and to correlate the findings with imagistic aspects.

These two ARGV produced pseudolesions, understood as focal fat sparing areas within diffuse fatty livers. These pseudolesions mimic liver tumours, therefore it is important to look for such an aberrant vessel in order to rule out other diagnoses.

Get Citation

Keywords

liver hyperdensity, third inflow, vitelline veins, umbilical veins

About this article
Title

Transient hepatic attenuation difference (THAD) or fat sparing? Aberrant right gastric vein (ARGV) determining a pseudolesion at the border of the IInd/IIIrd liver segments. Review of developmental concepts

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2023-09-07

Page views

190

Article views/downloads

195

DOI

10.5603/fm.96455

Pubmed

37691513

Keywords

liver hyperdensity
third inflow
vitelline veins
umbilical veins

Authors

Dan Alexandru Arhire
Marius Constantin Moraru
Razvan Maxim
Claudia Cristina Tarniceriu
Simona Alice Partene Vicoleanu
Anca Haisan
Irina Nedelcu
Alin Horatiu Nedelcu

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