Hepatopulmonary syndrome other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

There are no other imaging findings associated with hepatopulmonary syndrome.

OR

[Imaging modality] may be helpful in the diagnosis of hepatopulmonary syndrome. Findings on an [imaging modality] suggestive of/diagnostic of hepatopulmonary syndrome include [finding 1], [finding 2], and [finding 3].

Other Imaging Findings

Non invasive studies are preferred in diagnosis and management of patients with hepatopulmonary syndrome. Nevertheless in some cases such as likelihood of tromobotic accident, or when other noninvasive studies were not diagnostic, it is needed to evaluate the patient by means of angiography.

Indication for pulmonary angiography in known cases of HPS are as follows:

• Sever hypoxia (partial pressure of oxygen is < 60 mmHg),
• poor responsive to 100% oxygen
• Strong suspicion of direct arterio-venous communications that would be amenable to embolization, based on chest CT scan findings.

Rather than direct visualization of the pulmonary dilations (IPVSs), it can also demonstrate type of micro dilation in pulmonary vasculture as follows:

• Type 1 (minimal):Finely diffuse, spidery infiltrates; may progress to type 1 (advanced).
• Type 1 (advanced): Diffuse spongy or blotchy angiographic appearance
• Type 2: Discrete, localized arterio-venous communications