CTICasesHepatopulmonary syndrome
Imaging findings
Chest radiograph and CT show dilated peripheral pulmonary vessels extending all the way to the pleural surface in the lower lobes, in a patient with hepatitis C cirrhosis. Echocardiogram bubble study showed delayed microbubble entry into the left atrium, confirming an intra-pulmonary shunt.
Key takeaways
Hepatopulmonary syndrome is characterized by intrapulmonary vascular dilations leading to a right-to-left shunt and hypoxemia in patients with liver disease. Contrast echocardiography (bubble study) showing delayed left-sided opacification (3-6 cardiac cycles) is diagnostic.
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