Kobayashi S. Hepatic pseudolesions caused by alterations in intrahepatic hemodynamics. World J Gastroenterol 2021; 27(46): 7894-7908 [PMID: 35046619 DOI: 10.3748/wjg.v27.i46.7894]
Corresponding Author of This Article
Satoshi Kobayashi, MD, PhD, Professor, Department of Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, 5-11-80, Kodatsuno, Kanazawa 9200942, Ishikawa, Japan. satoshik@staff.kanazawa-u.ac.jp
Research Domain of This Article
Anatomy & Morphology
Article-Type of This Article
Frontier
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 14, 2021; 27(46): 7894-7908 Published online Dec 14, 2021. doi: 10.3748/wjg.v27.i46.7894
Hepatic pseudolesions caused by alterations in intrahepatic hemodynamics
Satoshi Kobayashi
Satoshi Kobayashi, Department of Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, Kanazawa 9200942, Ishikawa, Japan
Author contributions: Kobayashi S designed and wrote the manuscript, and collected relevant data and approve the final manuscript.
Conflict-of-interest statement: The author declares that he has no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Satoshi Kobayashi, MD, PhD, Professor, Department of Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, 5-11-80, Kodatsuno, Kanazawa 9200942, Ishikawa, Japan. satoshik@staff.kanazawa-u.ac.jp
Received: April 19, 2021 Peer-review started: April 19, 2021 First decision: June 23, 2021 Revised: June 23, 2021 Accepted: November 25, 2021 Article in press: November 25, 2021 Published online: December 14, 2021 Processing time: 235 Days and 1.3 Hours
Abstract
Hepatic pseudolesion may occur in contrast-enhanced computed tomography and magnetic resonance imaging due to the unique haemodynamic characteristics of the liver. The concept of hepatic arterial buffer response (HABR) has become mainstream for the understanding of the mechanism of the reciprocal effect between hepatic arterial and portal venous flow. And HABR is thought to be significantly related to the occurrence of the abnormal imaging findings on arterial phase of contrast enhanced images, such as hepatic arterial-portal vein shunt and transient hepatic attenuation difference, which mimic hypervascular tumor and may cause clinical problems. Third inflow to the liver also cause hepatic pseudolesion, and some of the cases may show histopathologic change such as focal hyperplasia, focal fatty liver, and focal sparing of fatty liver, and called pseudotumor. To understand these phenomena might be valuable for interpreting the liver imaging findings.
Core Tip: Understanding the characteristics of hepatic blood flow and the pathophysiology of pseudolesions caused by alterations in intrahepatic hemodynamics is important for diagnostic imaging of liver lesions. The concept of hepatic arterial buffer response, a unique mechanism for regulating hepatic blood flow, might be essential for elucidating the pathogenesis of hepatic arterial-portal vein shunting and transient hepatic attenuation difference on dynamic contrast-enhanced imaging of the liver. In addition, some pseudolesions are associated with histopathologic changes such as focal hyperplasia, focal fatty liver, and focal sparing of fatty liver. Understanding these phenomena may aid in interpreting liver imaging findings.
