A reticulated-mosaic pattern of the liver was identified on contrast-enhanced computed tomography in 4 of 20 patients with constrictive pericarditis or congestive heart failure. Reflux of contrast into a distended inferior vena cava and the hepatic veins was identified in 3 of the 4 patients. This abnormal enhancement pattern combined with hepatic venous or caval reflux of contrast indicates the presence of hepatic venous hypertension, and should not be mistaken for other abnormalities that may result in inhomogeneous hepatic enhancement.