Hepatic Vascular Disorders: Finding Based Approach to Making the Diagnosis

The unique vasculature of liver has made its’ vascular disorders of significant physiological consequences. Dual hepatic blood supply, one from the hepatic artery delivering oxygenated blood, the other from the portal vein which drains the GI tract delivering nutritive perfusion to the organ. This pattern of supply renders the organ relatively resistant to ischemia meanwhile providing substrate for its’ proper function. Hepatic sinusoids assume capillary anatomy and function draining into hepatic veins which despite having two major hepatic lobes three of them are present in the liver. Vascular hepatic disorders are classified into three main categories: A) Inflow disorders

B) Outflow disorders and C) Abnormal vascular connections (which are varied and could be arterioportal, arteriovenous and portovenous). Each of these categories have distinct imaging manifestations although overlap exists in these categories. We provide a brief case-based review of radiologic findings of each of these categories of abnormalities with an attempt to correlate the findings with the resultant physiological disturbances in each of these classifications.