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Transient Hepatic Attenuation Differences in Computed Tomography from Extrahepatic Portal Vein Compression
Radiology Case Reports
|June 16, 2016
Summary
Transient hepatic attenuation differences (THADs) can arise from extrahepatic conditions affecting portal vein flow. Radiologists should recognize these patterns, including peripheral THADs associated with portal vein thrombosis.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Transient hepatic attenuation differences (THADs) are imaging findings that require understanding of their underlying causes.
- Extrahepatic origins of THADs, particularly those involving the portal venous system, are less commonly described.
Observation:
- THADs were observed in five cases due to compression of the extrahepatic portal vein at the splenic vein confluence.
- Two additional cases of peripheral THADs resulted from main portal vein thrombosis.
Findings:
- Compression of the portal vein primarily caused left lobar THADs due to altered portal venous flow.
- Peripheral THADs were noted in cases of main portal vein thrombosis.
Implications:
- Compromised splenic and extrahepatic portal venous flow can lead to lobar and peripheral THADs.
- Radiologists must be aware of the "central pseudotumor" imaging artifact that can occur with peripheral THADs secondary to portal vein thrombosis.
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