Fig. 5.

Arterioportal shunt secondary to percutaneous ethanol injection therapy in a patient with HCC.

A. CT scan obtained during portal venous phase shows a perfusion defect at the site of previous percutaneous ethanol injection therapy (arrows), as well as multiple nodular tumors with iodized-oil uptake (arrowheads). An extrahepatic metastatic nodule, probably located at the previous needle tract for another percutaneous ethanol injection therapy (open arrow), is visible.

B. Celiac angiogram obtained before transarterial chemoembolization indicated an area of patchy staining (arrowheads) in the right hepatic lobe due to the presence of arterioportal shunt, as well as various other nodular staining lesions (arrows).

C. Precontrast CT obtained two weeks after transarterial chemoembolization shows wedge-shaped retention of iodized oil in the area corresponding to arterioportal shunt (arrowheads). Follow-up CT (not shown) indicated that in contrast to other nodular uptake by tumors, this retention had washed out.