Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Hepatopulmonary syndrome
- Radiologic Findings
- Fig 1. Chest PA shows basilar reticulonodular opacities, suggesting dilated peripheral vascular markings in both lung fields.
Fig 2-4. CT scans reveals prominent dilatation of pulmonary arteries and veins in subpleural area of both lungs.
Fig 5. CT scan at the level of upper abdomen shows lobulated bulging contour of liver with mild splenomegaly, suggesting liver cirrhosis
- Brief Review
- The diagnosis of hepatopulmonary syndrome is established with the following three criteria: chronic liver disease, increased alveolar-arterial gradient on room air, and evidence of intrapulmonary vascular dilatation. Hypoxemia is seen in one-third of decompensated cirrhotic patients. The most important mechanism is pulmonary vascular dilatation and consequent ventilation-perfusion mismatch. It is more accurate to describe the intrapulmonary process associated with these vascular dilatations as a diffusion-perfusion abnormality rather than as an intrapulmonary shunt. Hypoxia is believed to result from an inability of oxygen to diffuse to the center of massively dilated peripheral vessels.
Chest radiographs demonstrate basilar nodular or reticulonodular areas of increased opacity in 5%
- Please refer to
Case 113, Case 195, Case 627, -
KSTR Symposium 1999 Case 5
,
KSTR imaging conference 2017 Spring Case 12,
- References
1. Cris A. Meyer, Charles S. White, Kenneth E.Sherman. Diseases of the Hepatopulmonary Axis RadioGraphics 2009; 29:825
- Keywords
-
lung, vascular, hepatopulmonary Syndrome, liver cirrhosis,