ARRS 2022 Abstracts

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E1110. Imaging of Iatrogenic Hepatic Infarction: Review of Anatomy, Imaging Findings, and Risk Factors
Authors
  1. Isaac Levine; Case Western Reserve University; Cleveland Clinic Imaging Institute
  2. Tisileli Tuifua; Cleveland Clinic Imaging Institute; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
  3. Baljendra Kapoor; Cleveland Clinic Foundation; Cleveland Clinic Imaging Institute
  4. Erick Remer; Cleveland Clinic Foundation; Cleveland Clinic Imaging Institute
Background
Hepatic infarction is a rare complication most often described after liver transplant. Hepatic infarction has been increasingly described in the literature following other interventions such as transjugular intrahepatic portosystemic shunt (TIPS) placement and pancreaticoduodenectomy. This presentation will highlight the imaging findings and relevant anatomy among patients with hepatic infarct and provide clinical context for this finding in various procedures to aid diagnosis.

Educational Goals / Teaching Points
The goals of this exhibit are to provide an overview of the etiologies and risk factors for iatrogenic hepatic infarction; describe and illustrate findings on CT, MRI, and ultrasound, including lesion appearance, location, and evolution; and describe imaging findings of hepatic infarction complications such as superinfection.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Relevant anatomic and physiologic background will be provided as they pertain to hepatic infarction, including the dual supply of the liver and flow alterations following select procedures. Intervention-specific risk factors and etiologies for infarction will be described with this anatomic and physiologic context in mind. Risk factors for infarction will be described in liver transplantation, TIPS, pancreatic and hepatobiliary surgeries, and hepatobiliary radiofrequency ablation. A modality-based review of imaging findings and complications will highlight morphologic, localization, and evolution characteristics of hepatic infarcts, with an emphasis on modality and procedure-specific findings.

Conclusion
Morphologic appearance of infarcts changes over time and may depend in part on location of infarcted liver tissue. Specific segments of the liver are more prone to infarction, and susceptible segmental location may vary by procedure. An understanding of the morphology, location, evolution, and modality-specific appearance of hepatic infarcts is helpful for diagnosis of hepatic infarction following interventions.