Vascular Malformations

According to the Mullicken and Glowacki Classification, vascular malformations can be subdivided into: a) fast-flow forms, that comprise arteriove-nous malformations and arterioportal fistulas, b) slow-flow forms, that comprise portosystemic shunts and venous as well as lymphatic malformations, and c) combined forms [38]. The vast majority of vascular pseudolesions are due to fast-flow form malformations.

Arteriovenous Malformations (AVMs)

AVMs are congenital abnormalities in the formation of blood vessels that shunt blood through direct arteriovenous connections, without neoplastic tissue between these anomalous vessels. Clinically, these congenital abnormalities can be observed in neonates with congestive heart failure, hepatomegaly, portal hypertension, and anemia, or in late childhood and in adults in the clinical setting of hereditary haemorrhagic teleangiectasia associated with congestive heart failure, hepatic is-

Fig. 25a-d. Arterioportal shunts. HCC after liver biopsy. On the pre-contrast CT scan (a) a hypodense, round, well-defined nodule (arrowhead can be seen. In the arterial phase after contrast medium administration, a markedly hyperdense, triangular area (arrow) is visible near the nodule (b). In the portal venous phase (c) the area again appears isodense due to wash-out of contrast medium from this area and enhancement of the surrounding liver. Catheter angiography (d) confirms the presence of APS (arrow)

Fig. 25a-d. Arterioportal shunts. HCC after liver biopsy. On the pre-contrast CT scan (a) a hypodense, round, well-defined nodule (arrowhead can be seen. In the arterial phase after contrast medium administration, a markedly hyperdense, triangular area (arrow) is visible near the nodule (b). In the portal venous phase (c) the area again appears isodense due to wash-out of contrast medium from this area and enhancement of the surrounding liver. Catheter angiography (d) confirms the presence of APS (arrow)

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