CTICasesHepatopulmonary Syndrome
Imaging findings
In a patient with long-standing liver failure listed for transplant, CT shows numerous small, spidery, telangiectatic vessels extending to the pleural surface on both the dependent and non-dependent lung, some mild peripheral ground-glass opacity, and probable transpleural collateral vessels, in the setting of cirrhotic liver morphology.
Key takeaways
These findings are typical of hepatopulmonary syndrome, in which intrapulmonary vascular dilations and shunts develop in the setting of chronic liver disease, producing platypnea as patients become more short of breath upright than supine; a bubble study in such patients typically demonstrates delayed, extracardiac shunting corresponding to these visible intrapulmonary vascular dilatations.
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