Presence of delta sign on contrast enhanced CT SCAN suggests presence of –
**Core Concept**
The delta sign is a radiological finding observed on contrast-enhanced computed tomography (CT) scans, which is indicative of a specific vascular structure being compromised by a pathological process.
**Why the Correct Answer is Right**
The delta sign is caused by the presence of a patent arterial branch supplying blood to a tumor, which is encased in a network of dilated, tortuous, and sometimes thrombosed veins. This characteristic pattern is seen due to the slow flow of blood through the venous structures, resulting in a delayed enhancement of the veins on the CT scan. The arterial branch, which remains patent, enhances earlier than the surrounding venous structures, creating a "delta" shape on the CT image. This is typically seen in the context of a hepatic arteriovenous fistula (HAVF) or a hepatic arterial-venous malformation (AVM).
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because the delta sign is not typically associated with a portal venous system anomaly.
**Option B:** This option is incorrect because the delta sign is not a characteristic finding of a hepatic arterial aneurysm.
**Option C:** This option is incorrect because the delta sign is not a typical feature of a hepatic vein thrombosis.
**Clinical Pearl / High-Yield Fact**
The delta sign is a crucial radiological finding that should prompt further investigation into the possibility of a hepatic arteriovenous fistula or malformation, which can be a source of significant morbidity and mortality if left untreated.
**Correct Answer:** C. Hepatic arteriovenous fistula or malformation