Hepatic perivascular lymphedema: CT appearance

Area of Science:

• Radiology
• Hepatology
• Lymphatic Imaging

Background:

• Dilated hepatic lymphatics have been noted in liver transplant recipients.
• Similar CT findings of hepatic lymphatic dilatation and perivascular lymphedema were observed in patients without liver transplants.

Purpose of the Study:

• To describe the CT appearance of hepatic lymphatic dilatation and perivascular lymphedema in non-liver transplant patients.
• To identify underlying etiologies associated with these findings.
• To differentiate this condition from dilated intrahepatic bile ducts.

Main Methods:

• Retrospective review of CT scans and patient records over an 8-month period.
• Identification of 20 patients with findings of hepatic lymphatic dilatation and perivascular lymphedema.
• Categorization of underlying etiologies into posttraumatic obstruction, malignant lymphadenopathy, and congestive hepatomegaly.

Main Results:

• Twenty patients without liver transplants exhibited hepatic lymphatic dilatation and perivascular lymphedema on CT.
• Ninety percent (18 of 20) had underlying conditions causing increased lymph flow or obstruction.
• Etiologies included posttraumatic hepatic lymphatic obstruction, malignant lymphadenopathy, and cardiac decompensation-related congestive hepatomegaly.

Conclusions:

• Hepatic lymphatic dilatation and perivascular lymphedema on CT can occur in patients without liver transplants.
• These findings are often associated with underlying conditions affecting lymphatic flow or causing obstruction.
• Radiologists must recognize this appearance to prevent misinterpretation as dilated intrahepatic bile ducts.