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Abdominal Findings in Hereditary Hemorrhagic Telangiectasia: Pictorial Essay on 2D and 3D Findings with Isotropic Multiphase CT¹

¹ From the Departments of Radiology (H.S., M.G.D., J.G.F., A.W.S., T.J.V., D.M.H., J.L.F., C.H.M.) and Pulmonary and Critical Care Medicine (K.L.S.), Mayo Clinic, 200 First St SW, Rochester, MN 55905. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received March 5, 2007; revision requested May 9 and received July 16; accepted July 27. J.G.F. receives grant support from Siemens and E-Z-Em and has a license agreement with General Electric; J.L.F. receives grant support from E-Z-Em; C.H.M. receives grant support from Siemens and RTI Electronics; all other authors have no financial relationships to disclose. Address correspondence to J.G.F. (e-mail: fletcher.joel{at}mayo.edu).

The rapid evolution in multidetector computed tomographic (CT) technology has produced improvements in temporal and spatial resolution, leading to greater recognition of the spectrum of abdominal findings in hereditary hemorrhagic telangiectasia (HHT). In this multisystem vascular disorder, the abdominal findings are predominantly within the liver. Hepatic vascular lesions in HHT range from tiny telangiectases to transient perfusion abnormalities and large confluent vascular masses. Focal hepatic lesions are often associated with arteriovenous, arterioportal, or portovenous shunts. Pancreatic, splenic, and other vascular abnormalities are also observed because they are included in the field of view. By taking advantage of the increased z-axis spatial resolution and faster scanning times, and by using a bolus tracking technique, multiphase CT can be used to identify hepatic and extrahepatic lesions in HHT and to characterize the associated vascular shunts. Coronal maximum intensity projection images are particularly helpful in depiction of small hepatic vascular lesions.

© RSNA, 2008