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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
Affiliations- Radiology Clinic, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
- Arhimed Radiology, Hatman Sendrea No. 2, Iasi, Romania
- Department of Morpho-Functional Science I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Emergency Department, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
- Department of Emergency Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- ENT Department, Sf. Spiridon County Clinical Emergency Hospital, Iasi, Romania
- Radiology Clinic, Recovery Hospital, Iasi, Romania
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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.
Keywords
liver hyperdensity, third inflow, vitelline veins, umbilical veins
About this articleTitle
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
Issue
Article type
Case report
Published online
2023-09-07
Page views
206
Article views/downloads
214
DOI
Pubmed
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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