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Transient hepatic attenuation differences (THAD) not connected to focal lesions
S Colagrande1, L Carmignani, A Pagliari
1Dipartimento di Fisiopatologia Clinica, Sezione di Radiodiagnostica, Università degli Studi, Firenze, Italy.
La Radiologia Medica
|October 19, 2002
Summary
Transient hepatic attenuation differences (THAD) not linked to focal lesions can be classified by their cause, including portal vein issues, trauma, and inflammation. Helical CT aids in detecting these changes and associated vascular thrombi.
Area of Science:
- Radiology
- Hepatology
- Medical Imaging
Background:
- Transient hepatic attenuation differences (THAD) are observed in CT scans.
- Understanding THAD not associated with focal lesions is crucial for diagnosis.
Purpose of the Study:
- To evaluate helical CT for THAD without focal lesions.
- To establish an etiological and pathogenetic framework for THAD based on imaging characteristics.
Main Methods:
- Retrospective analysis of 130 biphasic helical CT liver examinations showing THAD.
- Categorization of THAD based on association with focal lesions (87 patients) or lack thereof (43 patients).
- Detailed assessment of THAD morphology, extension, and density, with comparison to healthy controls and follow-up imaging.
Main Results:
- 18 localized and 25 diffuse THAD were identified.
- Localized THAD correlated with portal branch thrombosis, biopsy, arterioportal shunting, Budd-Chiari syndrome, inflammation, or compression.
- Diffuse THAD patterns were associated with Budd-Chiari syndrome, heart failure, portal trunk thrombosis, cirrhosis, and biliary dilatation.
Conclusions:
- A classification for THAD unrelated to focal lesions is proposed, identifying four main causes: portal vein obstruction, inflow diversion, trauma, and inflammation.
- THAD identification can facilitate the detection of vascular thrombi.
- Helical CT, particularly the arterial dominant phase, is valuable for detecting and characterizing various hepatic diseases manifesting as THAD.