ACTIVE INTRAHEPATIC GADOLINIUM EXTRAVASATION FOLLOWING TIPS

A 31-year-old male patient had a transjugular intrahepatic portal syst emic shunt (TIPS) placed for acute Budd-Chiari syndrome secondary to p aroxysmal nocturnal hemoglobinuria (PNH), Post-procedure, he was antic oagulated for his underlying paroxysmal nocturnal hemoglobinuria, Afte r 11 days, he complained of upper abdominal pain and underwent magneti c resonance imaging (MRI), On immediate post-gadolinium spoiled-gradie nt-echo (SGE) images, active extravasation of gadolinium was depicted in one of two intrahepatic hematomas. Progression of layering of high signal gadolinium was shown from early to later phase post-gadolinium images. The active arterial bleeding was confirmed by conventional ang iography performed immediately following the magnetic resonance imagin g. (C) 1998 Elsevier Science Inc.