It is typically seen in superior vena cava obstruction, due to portosystemic venous shunting between the superior vena cava and the left portal vein via the internal mammary and paraumbilical veins (this can also be seen on CT).
Other conditions can cause increased uptake anywhere in the liver, including segment IV. These include liver abscesses, hemangioma, focal nodular hyperplasia, and hepatocellular carcinoma. Budd-Chiari syndrome typically causes focal uptake in the caudate lobe.
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