CTICasesHepatopulmonary Syndrome
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Imaging findings
CT shows very large, "juicy" central pulmonary vessels and myriad small vessels touching the pleural surfaces, especially along the diaphragm, appearing as "little vascular dots." This reflects shunting to the lungs.
Key takeaways
Hepatopulmonary syndrome involves intrapulmonary vascular dilations leading to shunting and hypoxemia in patients with liver disease. Imaging features include dilated central pulmonary arteries and numerous peripheral vessels extending to and touching the pleural surfaces. Diagnosis is supported by shunt fraction measurement and bubble studies to confirm intrapulmonary shunting (occurring after 5-9 beats).
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