Case 294: Yttrium 90 Radioembolization

Diagnostic Category:

Clinical Presentation:

61 year old man with hepatocellular carcinoma in hepatic segment VI, post Y90 radioembolization.

MR: Hepatic infarct after Y90 radioembolization

Imaging Findings:

MR done three months after radioembolization shows subsegmental wedge shaped area of irradiated liver parenchyma, with residual fibrovascular bundles in between as a result of Y90 treatment, representing radionecrosis. Avascular parenchyma of the treatment zone is similar to hepatic infarct, however penetrating portal triads are still enhancing.  Patient had preexisting thrombus in this subsegmental sectorial portal venous branch associated with HCC (see MR prior to treatment).