Fig. 23

Obliterative portal venopathy. 32-year-old female, with HIV infection and slightly increased bilirubin levels, who complained of increased abdominal volume. Axial (a) plain, (b) arterial, and (c) portal venous phase contrast-enhanced CT images show some morphologic liver changes, with hypertrophy of the caudate lobe, but regular contours and no atrophy of segment IV. Right PV is hypoattenuating before and after contrast material administration (yellow arrows), a feature suggesting non-acute thrombus. Hepatic parenchyma displays heterogeneous peripheral enhancement in arterial phase (b) due to compensatory increased arterial flow. This THED fades in portal venous phase (c). Some PH stigmata are present, as such splenomegaly, permeable umbilical vein (red arrow), and other varices. Liver biopsy was performed and OPV diagnosis pathologically confirmed