Figure 3.

A surveillance CT of a 73-year-old female with non-alcoholic fatty liver disease related cirrhosis showed a 20 mm hepatocellular carcinoma in Segment V. This was treated with microwave ablation. (A) Axial non-contrast-enhanced CT demonstrates the position of the microwave needle. (B) Follow up axial arterial and (C) Axial portovenous post contrast-enhanced CT shows new onset of moderate ascites with blood results demonstrating worsening of hepatic function in keeping with decompensated portal hypertension. Note there is early opacification of the right portal vein on the arterial phase imaging (arrow). (D) Catheter hepatic angiography demonstrates an arterioportal shunt. (E) Angiography images demonstrate successful closure of arterioportal shunt with coil. The patient’s ascites and patient’s liver function improved.