Atrophy of anterior and medial segments commonly follows development of focal confluent fibrosis in cirrhosis
Look for signs of portal hypertension (varices, ascites, etc.)
• Postsurgical resection
For hepatic resection, incisions can be made along longitudinal or transverse scissurae or both combined
• Post chemoembolization or ablation
Hyperattenuation of atrophic liver parenchyma
Check prior imaging studies and medical records for evidence of prior tumor and treatment
CLINICAL ISSUES
• Usually asymptomatic
DIAGNOSTIC CHECKLIST
• Conditions including cirrhosis, atrophy secondary to biliary obstruction, hepatic surgery, and trauma can mimic agenesis and should be ruled out 1st
TERMINOLOGY
Synonyms
• Agenesis or hypoplasia of hepatic lobes or segments
Definitions
• Lobar agenesis or hypoplasia is an uncommon developmental anomaly with absence of liver tissue usually to right or left of gallbladder fossa without prior surgery or disease
IMAGING
General Features
• Best diagnostic clue
Absence of right or left hepatic vein, portal vein and its branches, and intrahepatic ducts
– If none of these structures are visible, agenesis is substantiated
• Location
Most common segments involved
– Right lobe: Segments 5 and 8 (anterior segments)
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