Imaging Diagnosis of Hepatic Metastases of Pancreatic Carcinomas : Significance of Transient Wedge-shaped Contrast Enhancement Mimicking Arterioportal Shunt

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OBJECTIVE. We aimed to evaluate the imaging findings of hepatic metastases from pancreatic carcinomas, especially wedge-shaped enhancement and its etiology.MATERIALS AND METHOD. Dynamic CT and MR images were performed in 87 patients with liver metastases from pancreatic carcinomas, and CT during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) in 51 patients.RESULTS. In 37 patients, more than one metastatic lesions accompanied with wedge-shaped enhancement on dynamic studies and CHTA, and wedge shaped perfusion defect on CTAP. Six patients showed multiple wedge-shaped enhancement which was initially diagnosed as multiple arterioportal shunts (AP shunts). However, metastatic tumors appeared within the area of wedge-shaped enhancement on follow-up CT and/or MR images After all, 43 of 87 patients (49%) had AP shunt like contrast enhancement adjacent to liver metastases.CONCLUSION. Liver metastases from pancreatic carcinomas frequently show transient wedge-shaped enhancement, and should not be misdiagnosed as nontumorous arterioportal shunts.