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Ultrasound with Doppler evaluation of congenital hepatic vascular shunts

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Abstract

Congenital aberrant hepatic vascular communications result from intrahepatic or extrahepatic errors in vascular development or involution during the transition from fetal to newborn hepatic circulation. These hepatic vascular shunts can be fortuitously discovered and asymptomatic, or can cause symptoms of varying severity, often presenting diagnostic dilemmas. Some hepatic vascular shunts resolve spontaneously while others require interventional radiologic or surgical closure. Affected patients are often first studied with real-time and Doppler ultrasound, so radiologists should familiarize themselves with the expected ultrasound findings of these vascular shunts for effective diagnosis, triage and management. In this review, the authors focus on ultrasound and Doppler findings of hepatic vascular shunts with underlying embryology, clinical features and management strategies. Broadly, these aberrant hepatic vascular communications include portosystemic venous shunts (which can be intra- or extrahepatic and include persistent patent ductus venosus), arterioportal, arteriovenous or mixed shunts.

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Authors and Affiliations

  1. Pediatric Imaging Section, Department of Imaging Sciences, Golisano Children’s Hospital, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY, 14642, USA

    Apeksha Chaturvedi & Nina B. Klionsky

  2. Department of Pediatric Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    David Saul

Authors
  1. Apeksha Chaturvedi
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  2. Nina B. Klionsky
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  3. David Saul
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Correspondence to Apeksha Chaturvedi.

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Chaturvedi, A., Klionsky, N.B. & Saul, D. Ultrasound with Doppler evaluation of congenital hepatic vascular shunts. Pediatr Radiol 48, 1658–1671 (2018). https://doi.org/10.1007/s00247-018-4247-0

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  • DOI: https://doi.org/10.1007/s00247-018-4247-0

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