Purpose or Case Report: The purpose of this study was to demonstrate manifestations of MSCT in Abernethy malformation and its diagnostic value.
Methods & Materials: Twelve pediatric cases of Abernethy malformation were admitted to the center between July 2011 and September 2016. All the 12 patients (seven males and five females) performed MSCT and DSA. The patient ages ranged from 3 and 14 years old (median age 9 years old). The clinical records of the patients were thoroughly analyzed. MSCT angiography was performed on a 16-row CT scanner (Lightspeed 16, General Electric Medical Systems) or 64-row CT scanner (GE Discovery CT 750 HD, Waukesha, WI). CT raw data were transferred to an Advantage Windows 4.2 or 4.6 workstation (General Electric Medical Systems, Waukesha, WI). Maximum intensity projection (MIP) and multiplanar reformation (MPR) were the primary methods of visualization for evaluation. DSA was performed with a digital subtraction angiography machine (LC-LP biplane machine, General Electric Medical Systems) in all patients.
Results: Three cases were type Ib Abernethy malformation and nine cases were type II Abernethy malformation．Two cases of type II Abernethy malformation were misdiagnosed to type Ib Abernethy malformation in MSCT. Among the twelve patients, nine presented with single vessel shunt between portal vein and IVC, one with shunt between portal vein and left renal vein, one with shunt between splenic vein and right iliac vein, one with shunt between splenic vein and left iliac vein. Other clinical information of these patients includes congenital heart disease, pulmonary hypertension, diffuse pulmonary arteriovenous fistula, abnormal liver function, hepatic nodules, elevated blood ammonia, hepatic encephalopathy.
Conclusions: MSCT can exactly diagnose type II Abernethy malformation and show the exact location of the portacaval shunt. Sometimes it is hard to make the certain diagnosis between Abernethy type Ib and II in MSCT, then DSA will help while necessary.