Case 82: Hepatic Infarct

Diagnostic Categories:

Clinical Presentation:

59 year old woman with gastric sarcoma. Shortly after gastrectomy.

CT: Typical, wedge shaped, hypovascular

Imaging Findings:

CT shows a wedge shaped hypoperfused portion in segment 3, typical for a new subsegmental hepatic infarct. Note sharp delineation of the infarct ("straight border sign" outlining the vascular territory; arrowheads on 4th image of top row). Normal proximal left hepatic artery (arrowhead, 2nd image of top row) and portal vein and typical enhancement of liver capsule around the infarcted zone (arrow, 2nd image of top row). Note that the liver contour over the infarcted segment is slightly retracted (arrow, 2nd image of top row).

Two years later, the affected portion in segment 3 is atrophic (bottom row of images).   The left hepatic artery is atrophic (area of arrowhead on 2nd image of bottom row).