Hepatic pseudolesion around the falciform ligament: prevalence, aberrant venous supply, and fatty infiltration evaluated by multidetector computed tomography and magnetic resonance imaging.

Purpose: The aim of this study was to determine the prevalence and aberrant venous supply (inferior veins of Sappey) of hypoattenuating hepatic pseudolesions seen around the falciform ligament on portal-dominant phase multidetector computed tomography (MDCT) and the frequency of fatty infiltration of these pseudolesions on chemical-shift magnetic resonance imaging.
Materials and Methods: Portal-dominant phase abdominal MDCT examinations of 728 patients were evaluated for the presence of a pseudolesion around the falciform ligament, and those with a presumed pseudolesion underwent chemical-shift magnetic resonance imaging to detect the fatty infiltration. Reconstructed MDCT images were investigated for the presence of an inferior vein of Sappey, and 30 patients without a pseudolesion were evaluated as a control group.
Results: A total of 160 pseudolesions were detected around the falciform ligament in 146 (20%) patients. The longest diameter of the pseudolesions was in the craniocaudal direction in most patients (61%). An inferior vein of Sappey supplying these pseudolesions was depicted in 40 (27%) patients, and it was highly significant (P = 0.001) compared with the controls for the presence of a pseudolesion around the falciform ligament. Fatty infiltration was found in 47 (29%) patients.
Conclusions: Hepatic pseudolesions around the falciform ligament are frequently encountered on portal-dominant phase MDCT images. Detection of craniocaudal extension, inferior veins of Sappey, and fatty infiltration of these pseudolesions, which were firstly described in this article, with the largest subject group based on cross-sectional imaging, might be valuable in excluding true tumors.