Liver Disease in Children: An Atlas of Angiography and by Francis Brunelle

By Francis Brunelle

In contemporary years, advancements in ultrasound, computed tomography and magnetic resonance imaging have made vital alterations within the perform of diagnostic radio­ logy. Concomitantly, invasive radiology for either diagnostic and healing reasons has grown right into a speedily evolving subspecialty. this article represents a landmark in paediatric radiology. the 3 authors are special radiologists who, during the last twenty years, have tremendously contributed to paediatric hepatology. Their pioneering paintings within the region of splanchnic angiography and diagnostic in addition to healing cholangiography was once facilitated via their shut day by day interplay with the Paediatric Liver affliction Unit at Höpital Bicetre. The contents and the structure of this "atlas" are testimony to their wisdom of scientific hepatology and to their large event in invasive paediatric radiology. The out­ status caliber of the photographs is greater via acceptable scientific descriptions so as to support the reader comprehend the symptoms for those tactics, their accuracy and limitations.

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It probably corresponds to peribiliary veins which shunt the presinusoi:dal block present in congenital hepatic fibrosis. The association of hepatofugal and hepatopetal collateral veins contrasting with a patent portal trunk and proximal branches is unusual and should suggest the diagnosis of congenital hepatic fibrosis. In one case aneurysmal dilatation of the left portal vein branch was found. Opacification of the Arantius duct was also seen in another case. Arterial hypervascularity was also seen probably compensating the portal hypoperfusion.

Duplication of the intrahepatic portal branches. Opacification of the oesophageal varices throu gh the left gastric vein and posterior gastric veins. Splenorenal shunt (arrow) . b Percutaneous transhepatic cholangiography. Multiple communicating cysts are seen through out the liver. Fig. 48. Congenital hepatic fibrosis: 13 years of age. a Splenoportogram . Portal pressure: 27 cm H 20. arge left gastric vein is seen. b Close-up view demonstrates clearly the intrahepatic duplication, sometimes triplication of the intrahepatic portal vein branches.

Budd-Chiari synd rome: 15-yea r-old boy presenting w ith a right corti cosurenaloma . Preopera ti ve work-up. Inferior vena cava opacification lateral projection. a Displacement an d localised thrombosis of th e retrohepatic portion of th e inferior vena cava (arrow). b Opacification of the suprahepatic portion of the inferior vena cava by a network of coll a teral hepatic veins (arrowheads). There is reflux of cantrast medium in the renal vei ns a ndin the azygos system. Surgical Portosystemic Shunts Treatment of portal hypertension includes surgical portosystemic shunts (Fig.

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