Segmental Hypertrophy

In conditions such as cirrhosis, Budd-Chiari syndrome or primary sclerosing cholangitis the liver may be dysmorphic in appearance. In the chronic phase of Budd-Chiari syndrome, the abnormal vascularization tends to be located more peripherally and to be most prominent around the caudate lobe due to its separate autonomous venous drainage. Consequently, this liver portion may increase in volume.

In sclerosing cholangitis, atrophy and compensatory hypertrophy of the liver parenchyma are consequences of chronic obstruction of the segmental bile duct. This leads to atrophy of the affected segments and compensatory hypertrophy in other segments in which bile flow is maintained (Fig. 21). On CT and MR imaging the resulting liver hypertrophy appears more hyperdense and hy-perintense on Tl-weighted images respectively, compared to that of the surrounding parenchyma

Hypertrophie Segment
Fig. 21. Segmental hypertrophy. Patient with primary sclerosing cholangitis. Color Doppler US reveals prominent vascular structures located around segment I of the liver. This segment demonstrates a progressive increase in size due to atrophy of other segments affected by sclerosing cholangitis

(Figs. 22,23). In some cases the segmental hypertrophy has a pseudotumoral aspect.

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