Case 174:   Perfusion Abnormality (THAD/THID)

Diagnostic Category:

Clinical Presentation:

37 year old woman with Non-Hodgkins Lymphoma and venous thromboses.

CT: Retrograde contrast via veins within the falciform ligament.

Imaging Findings:

The first three images of arterial phase CT adjusted to bone window show large areas of the left hepatic lobe densely opacified with contrast. The etiology of this is an occlusive thrombus in the SVC and left brachiocephalic and subclavian veins. Contrast is forced by the power injector to the left hepatic lobe retrogradely via subcutaneous thoracic collaterals, which communicate via the left internal mammary, superior epigastric veins and the superior veins of Sappey through the falciform ligament.