Hepatic infarction secondary to arterial insufficiency in native livers: CT findings in 10 patients.

Abstract

To describe the computed tomographic (CT) appearance of hepatic infarcts resulting from arterial insufficiency in native livers. The authors retrospectively reviewed the clinical and imaging findings in 10 patients (five men, five women; age range, 28-70 years) with 14 hepatic infarcts seen over 3 years. CT scans were analyzed for infarct appearance, vessel patency, and evolution of infarct pattern over time. Hepatic infarction resulted from hepatobiliary surgery (n = 6), radiologic intervention (n = 3), and celiac occlusion secondary to antiphospholipid syndrome (n = 1). All 14 infarcts were of low attenuation, peripheral, and wedge-shaped. Occluded arterial vessels were identified in eight patients. Follow-up CT revealed infarct diminution with parenchymal atrophy and scarring (n = 5), progressive liquefaction (n = 2), or both parenchymal atrophy and progressive liquefaction (n = 1). Sudden interruption of hepatic arterial flow may cause acute native liver infarction. Patients at risk include those with underlying vascular disease who undergo complicated surgical procedures and those undergoing peripheral arterial embolization.