Aberrant Gastric Venous Drainage Research Articles

Aberrant gastric venous drainage and associated atrophy of hepatic segment II: computed tomography analysis of 2021 patients.

To investigate the prevalence and patterns of aberrant gastric venous drainage and associated atrophy of the hepatic segment on contrast-enhanced computed tomography (CT). Two radiologists retrospectively reviewed contrast-enhanced CT images from 2021 patients who underwent cone-beam CT-guided chemoembolization between January 2013 and December 2018. They determined the presence or absence of an aberrant gastric vein(s) and its drainage site by consensus, and qualitatively analyzed the presence or absence of atrophy of segments II or III. In cases of disagreement between the two reviewers regarding the presence of atrophy, quantitative analysis was performed using dedicated software. A total of 31 aberrant right gastric veins were revealed on CT (1.5%), most of which drained into P2 (n = 8), the S2/3 border zone (n = 8), S2 (n = 6), or S4 (n = 5). An aberrant left gastric vein was observed in 21 (1.0%) patients, and P2 was the most common drainage site (n = 13) in these patients. Atrophy of segment II was more frequently observed among patients with aberrant gastric veins than among those without (26.9% versus 4.1%; p < 0.001). In addition, an aberrant gastric vein draining into P2 was most frequently accompanied by segment II atrophy (47.6%). Aberrant right and left gastric veins were observed in 1.5% and 1.0% of patients, respectively. Atrophy of segment II was frequently observed in patients with aberrant gastric veins, especially those that drained into P2.

A case of focal fatty liver with aberrant gastric venous drainage after gastrectomy

A case of focal fatty liver with aberrant gastric venous drainage after gastrectomy

Aberrant gastric venous drainage in focal fatty liver of segment IV: demonstration with sonography.

Aberrant gastric venous drainage in focal fatty liver of segment IV: demonstration with sonography.

Aberrant gastric venous drainage into the medial segment: demonstration by color Doppler sonography.

Aberrant gastric venous drainage (AGVD) into the posterior edge of the medial segment of the liver (segment IV) is the main cause of pseudolesion on computed tomography (CT) during arterial portography. We estimated the prevalence of AGVD into the medial segment of the liver with color and power Doppler ultrasound (US). Screening gray-scale and color Doppler and power Doppler US were performed in 100 consecutive patients. AGVD was defined as a venous structure that ascended parallel to the main portal vein and drained independently into segment IV. AGVDs were observed in eight of 100 patients (8%) with color and power Doppler US. Power Doppler US depicted these veins more clearly than did color Doppler US. Gray-scale US did not show any AGVDs. Two of eight patients with AGVDs detected by color Doppler US underwent celiac arteriography and CT during arterial portography (CTAP). In these two patients, celiac arteriography directly demonstrated AGVDs draining into segment IV, which revealed nontumorous perfusion defects (pseudolesions) on CTAP. Color and power Doppler US are useful imaging methods for demonstrating AGVDs.

Aberrant Gastric Venous Drainage in a Focal Spared Area of Segment IV in Fatty Liver: Demonstration with Color Doppler Sonography

Aberrant Gastric Venous Drainage in a Focal Spared Area of Segment IV in Fatty Liver: Demonstration with Color Doppler Sonography

Aberrant gastric venous drainage in a focal spared area of segment IV in fatty liver: demonstration with color Doppler sonography.

To clarify the correlation between aberrant gastric venous drainage and a focal spared area at the posterior edge of segment IV in fatty liver by using color Doppler ultrasound (US). Seventeen patients with fatty liver were examined with gray-scale, color Doppler, and power Doppler US. In one patient with a focal spared area, arteriography and computed tomography (CT) were performed during injection of contrast medium into the right gastric artery. Focal spared areas of fatty liver at segment IV were shown in five of 17 patients. In all five patients with a focal spared area, aberrant gastric venous drainage was observed with color Doppler US. Power Doppler US depicted aberrant gastric venous drainage more clearly than color Doppler US. On the other hand, no definite aberrant gastric venous drainage was seen in the 12 patients who had no focal spared area. In one patient who underwent selective arteriography of the right gastric artery and CT arteriography, aberrant gastric venous drainage into segment IV was directly demonstrated. Focal spared areas at segment IV in fatty liver correlate strongly with aberrant gastric venous drainage. Noninvasive imaging methods such as color and power Doppler US are useful for depicting these aberrant drainage veins.

Aberrant gastric venous drainage in cirrhotic livers: imaging findings in focal areas of liver parenchyma.

To analyze imaging finding in focal areas of liver parenchyma with aberrant gastric venous drainage (AGVD) in cirrhotic livers. Eighteen patients with AGVD confirmed with computed tomography (CT) during arterial portography and arteriography underwent ultrasound (US) (n = 18), CT (n = 18), magnetic resonance (MR) imaging (n = 12), dynamic CT (n = 14), and dynamic MR imaging (n = 8). Imaging and histologic (n = 2) findings were analyzed. The focal area with AGVD was hypoechoic on US scans (n = 7), hypoattenuating on CT scans (n = 4), hyperintense on T1-weighted MR images (n = 6), and hypointense on T2-weighted MR images (n = 5). Early enhancement was seen with dynamic CT (n = 8) and with dynamic MR imaging (n = 6), without definite staining on arterial phase of arteriography. Histologic findings revealed hyperplastic changes of liver. The imaging findings, except for early enhancement, were very similar to those of adenomatous hyperplasia or well-differentiated hepatocellular carcinoma. The early enhancement was considered due to early venous return compared with that of the surrounding liver.

Focal sparing of segment IV in fatty livers shown by sonography and CT: correlation with aberrant gastric venous drainage.

One of the most common sites of focal sparing in fatty livers (focal spared area) shown by sonography or CT is the posterior edge of segment IV. The differentiation of such a focal spared area from tumor has been a diagnostic challenge. The purpose of this study was to determine if a correlation exists between the focal spared area at the posterior edge of segment IV in fatty liver and the decrease of portal perfusion from the main portal vein due to aberrant gastric venous drainage directed into segment IV. Seventeen patients with fatty liver diagnosed on the basis of sonographic and CT findings who had hepatic arteriography and/or CT during arterial portography (CTAP) were included in the study. Seven patients had a focal spared area more than 2 cm in the longest diameter at the posterior edge of segment IV, and 10 patients did not have a focal spared area. The frequency of aberrant gastric venous drainage shown by arteriography (17 patients) and/or by CTAP (15 patients) was compared in the two groups of patients. Hepatic arteriography showed aberrant gastric venous drainage in all patients who had a spared area, and CTAP showed a portal perfusion defect at the posterior edge of segment IV in all five patients with a focal spared area who underwent CTAP. On the other hand, no definite aberrant gastric venous drainage and portal perfusion defect were seen in any patient without a spared area. The difference in the frequency of aberrant gastric venous drainage between the two groups of patients was statistically significant (chi-square test, p < .0001). Our results show that a strong correlation exists between the focal spared area at the posterior edge of segment IV in fatty liver and aberrant gastric venous drainage directed to segment IV. Focally decreased blood flow from the main portal vein associated with aberrant gastric venous drainage is a likely cause of the focal spared area. This fact is important for the differential diagnosis of hepatic tumors.

Pseudolesion in segment IV of the liver at CT during arterial portography: correlation with aberrant gastric venous drainage.

To analyze the correlation between pseudolesions seen in segment IV of the liver and aberrant gastric venous drainage (AGVD). Twenty-two patients with a pseudolesion in the posterior edge of segment IV of the liver (group A) and 100 randomly selected patients without pseudolesions (group B) underwent computed tomography during arterial portography (CTAP) and hepatic arteriography. The frequency of the visualization of AGVD to segment IV was compared for groups A and B. AGVD was seen at arteriography in 18 of 22 patients in group A. None of the patients in group B had AGVD. The difference in the frequency of angiographically visible AGVD was statistically significant (chi 2 test, P < .01). AGVD is the main cause of pseudolesions in the posterior edge of segment IV of the liver.