Hepatic capsular and subcapsular pathologic conditions: demonstration with CT and MR imaging

Area of Science:

• Hepatology
• Radiology
• Abdominal Imaging

Background:

• Pathologic conditions and pseudolesions frequently occur in the liver's capsular and subcapsular regions.
• These entities are influenced by the liver's unique anatomical and hemodynamic features, including subdiaphragmatic pressure and accessory blood supply.
• Various routes, such as peritoneal, hematogenous, biliary, and ligamentous, can lead to pathology in these regions.

Purpose of the Study:

• To elucidate the spectrum of pathologic conditions and pseudolesions in the hepatic capsular and subcapsular regions.
• To emphasize the role of liver anatomy and hemodynamics in the presentation of these entities.
• To guide radiologists in differentiating true lesions from pseudolesions using cross-sectional imaging.

Main Methods:

• Review of cross-sectional abdominal imaging findings.
• Analysis of anatomic and hemodynamic characteristics of the liver.
• Correlation of imaging findings with known pathologic conditions and pseudolesions.

Main Results:

• A variety of pathologic conditions and pseudolesions are identified in the hepatic capsular and subcapsular regions.
• Anatomical factors (e.g., perihepatic ligaments) and altered hemodynamics contribute to the formation of these entities.
• Computed tomography and multiphasic magnetic resonance imaging are crucial for characterization.

Conclusions:

• Understanding the liver's specific anatomy and hemodynamics is essential for diagnosing capsular and subcapsular abnormalities.
• Radiologists must be familiar with the diverse range of conditions and pseudolesions in these regions.
• Accurate differentiation between true and pseudolesions improves patient diagnosis and management.