Transient Subsegmental Hepatic Parenchymal Enhancement on Dynamic CT: A Sign of Postbiopsy Arterioportal Shunt

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Abstract
Our goal was to verify the correlation between the arterioportal shunt caused by liver biopsy injury and wedge-shaped early transient subsegmental parenchymal enhancement (TSPE) of the liver during helical dynamic CT. Twenty-one consecutive patients with suspected hepatic tumor underwent percutaneous needle biopsy. Helical dynamic CT scans at arterial, portal venous, and delayed phases were obtained before and after biopsy. CT images were reviewed for the presence of TSPE during the arterial phase of dynamic CT. Hepatic arteriograms were obtained in all patients and reviewed for the presence of arterioportal shunt. Wedge-shaped TSPE was observed on postbiopsy CT in 8 (38%) of the 21 patients along the needle path. In all of these patients, subsegmental arterioportal shunt was confirmed by hepatic angiograms. Wedge-shaped TSPE is commonly observed along the biopsy needle path and is due to arterioportal shunt caused by biopsy.