Diffuse Cerebral Edema and Impending Herniation Complicating Hepatic Encephalopathy in Hereditary Hemorrhagic Telangiectasia

Figure 2

Coronal and axial late arterial phase abdominal CT imaging demonstrating hepatic arteriovenous shunting. (a) Coronal reconstruction showing hepatic arterial enhancement, the portal venous system is not opacified with contrast. There is early contrast filling of the hepatic veins and the inferior vena cava consistent with the hepatic arteriovenous shunting. (b) Axial slice through the level of the portal vein shows no contrast opacification of the portal system. (c) Axial slice through the level of the hepatic vein shows contrast enhancement. Incidentally noted is a markedly dilated stomach filled with blood products from gastrointestinal angiodysplasia.

(a)

(b)

(c)