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DOI: 10.1148/rg.285075089
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RadioGraphics 2008;28:1307-1323
© RSNA, 2008

EDUCATION EXHIBIT

Hepatic Capsular and Subcapsular Pathologic Conditions: Demonstration with CT and MR Imaging1

Jun Woo Lee, MD, Suk Kim, MD, Sang Wook Kwack, MD, Chang Won Kim, MD, Tae Yong Moon, MD, Suck Hong Lee, MD, Mong Cho, MD, Dae Hwan Kang, MD, and Gwang Ha Kim, MD

1 From the Departments of Diagnostic Radiology (J.W.L., S.K., S.W.K., C.W.K., T.Y.M., S.H.L.) and Gastroenterology (M.C., D.H.K., G.H.K.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1–10 Ami-Dong, Seo-gu, Busan 602-739, Korea. Recipient of a Certificate of Merit for an education exhibit at the 2006 RSNA Annual Meeting. Received May 2, 2007; revision requested November 2 and received December 16; accepted January 11, 2008. Supported by Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan, Korea. Address correspondence to J.W.L. (e-mail: junwlee{at}pusan.ac.kr).

A variety of pathologic conditions and pseudolesions occur at the capsular and subcapsular regions of the liver and are detected with cross-sectional abdominal imaging. These entities are related to anatomic and hemodynamic characteristics of the liver such as negative subdiaphragmatic pressure, connection with other viscera and extraperitoneal sites by the perihepatic ligaments, and a "third inflow" of blood from sources other than the usual hepatic arterial and portal venous sources. Pathologic conditions can affect the hepatic capsular and subcapsular regions by way of peritoneal, hematogenous, biliary, and perihepatic ligamentous routes. Pseudolesions or benign conditions may also be identified on the basis of altered hemodynamics of the liver. Computed tomography and magnetic resonance imaging with a multiphasic approach can be used to identify and characterize these entities. Familiarity with the wide spectrum of pathologic conditions and pseudolesions at the hepatic capsular and subcapsular regions and precise knowledge of the anatomic and hemodynamic characteristics of the liver will aid the radiologist in diagnosing pathologic conditions and differentiating pseudolesions from true lesions.

© RSNA, 2008






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