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Erschienen in:
01.09.2009
Transient hepatic attenuation difference (THAD) in biliary duct disease
Erschienen in: Abdominal Radiology | Ausgabe 5/2009
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Background
THADs are associated with a wide spectrum of hepato-biliary pathologies. The aim of this paper is to find out the role of THADs in the imaging assessment of biliary diseases. We performed a retrospective study to establish the frequency of arterial phenomena in patients with specific biliary diseases.
Methods
Out of 1833 patients who underwent upper abdomen biphasic CT (2003–2007), we selected those with the following diagnoses: biliary duct dilation due to extrahepatic obstruction (20 patients-group A), intrahepatic-hilar cholangiocellular-carcinoma (19 patients-group B), and cholangitis (14 patients-group C). THAD presence/pattern was assessed for each group. Patients without any demonstrable clinical/imaging signs of liver/biliary pathology (1124) were the control group.
Results
THADs were observed in 36/53 (67.9%) and 20/1124 (1.78%) in study and control groups respectively, with significant association between each diagnostic group and THAD patterns (P < 0.0001). Eleven out of 20 (55%) group A patients showed peribiliary-THAD around dilated biliary tracts; 15/19 (79%) group B patients demonstrated portal involvement and sectorial-THAD; 10/14 (71%) group C patients revealed polymorphous-THAD all along inflamed biliary duct.
Conclusions
However, THADs are complex phenomena, their evaluation can be an additional diagnostic tool in patients with a biliary pathology. Diffuse peribiliary, sectorial, and polymorphous-THADs show a good rate of correlation (P < 0.0001) with biliary duct ectasia, portal infiltration, and cholangitis, respectively.