Not hepatic infarction: Cold quadrate sign
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Updated: Dec 10, 2025

Portable Thermographic Screening for Detection of Acute Wallenberg's Syndrome
Published on: September 19, 2019
Anderson H Kuo1, Sunita D Srivastava2, Samantha G Harrington1
1Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States of America.
Abstract:
A 50-year-old male presented with bilateral lower extremity plain is found to have a wedge-shape hypodense region in the hepatic quadrate lobe. The hypoenhancement was thought to be a result of systemic-portal venous shunting due to IVC obstruction, a "cold" version of the classically described hot quadrate sign. Follow-up CT confirmed the diagnosis. Venous drainage pathway for both hot and cold quadrate signs is discussed.
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