Purpose or Case Report: Congenital vascular anomalies of the liver are rare entities that take on different physical forms and clinical presentations, with imaging being highly important in the diagnosis and follow-up of these entities. The purpose of this educational presentation is to provide a multimodality imaging review of several different congenital vascular anomalies of the liver that have been observed at a single pediatric tertiary care center. These include infantile hepatic hemangiomas, congenital portosystemic shunts, and congenital intrahepatic arterioportal shunt. The clinical course and management/treatment for each of these entities, to also include the role of imaging in follow-up, will also be briefly discussed.
Methods & Materials: Radiologic imaging findings seen with different congenital vascular anomalies of the liver, to include case examples, will be reviewed. Imaging modalities include ultrasound, CT/CTA, MR/MRA, and catheter-based angiography. The clinical course and treatment of these entities will also be reviewed.
Results: Imaging findings seen in different congenital vascular anomalies of the liver vary and can be nuanced, with each imaging modality serving as its own piece of the puzzle in the work-up of these entities as well as having findings that correlate with one another. Infantile hepatic hemangiomas are subdivided into three types: focal, multifocal, and diffuse. Congenital portosystemic shunts are subdivided into type I (end-to-end shunt) and type II (side-to-side shunt). Type I congenital portosystemic shunts are further subclassified as type Ia or type Ib. The clinical course and treatment of these entities vary and can include a single or combination of the following: observation, medical, endovascular, and surgical intervention. Imaging is not only important in the diagnosis of these entities, but also aids in clinical management and decision making at both initial presentation and follow-up.
Conclusions: After reviewing this educational presentation, the reader will be able to recognize the imaging features for the spectrum of congenital vascular anomalies of the liver. The reader will also have been informed of management/treatment options and understand the role of imaging in follow-up of these entities.