Seung Soo Kim MD, Presenter: Nothing to Disclose

Sang Won Kim MD, Abstract Co-Author: Nothing to Disclose

Hyeong Cheol Shin, Abstract Co-Author:

Il Young Kim, Abstract Co-Author: Nothing to Disclose

We have observed transient hepatic attenuation differences (THADs) in some patients with acute hepatitis who underwent dynamic enhanced CT. Our objective was to describe the THADs on dynamic computed tomography in patients with viral hepatitis who had no evidence of cirrhosis.

After excluding patients who had known causative factors for the development of THAD, a retrospective review of dynamic CT scans in 67 patients with viral hepatitis was performed to determine whether THAD was present. The patients were assigned to 3 groups according to the magnitude of alanine aminotransferase (ALT) level alteration (normal to mild, moderate, and marked) or hepatitis type (acute hepatitis, acute exacerbation of chronic hepatitis, and chronic infection), and differences in the presence of various CT features including THAD among these groups were evaluated.

Of the 67 patients, 23 had THAD on arterial phase CT. Five THADs observed had a focal pattern, and 18 THADs had a diffuse pattern. Five focal THADs occurred secondary to aberrant blood supply and arterioportal shunts. All of the diffuse THADs were observed in patients with marked ALT level alteration (ALT level > 400 IU/L) and in patients with a clinical diagnosis of acute hepatitis or acute exacerbation of chronic hepatitis. In addition, there were significant differences of the presence of other CT findings including hepatomegaly, periportal tracking, gallbladder wall thickening, perihepatic lymphadenopathy, and splenomegaly among these groups (each P < 0.05).

A diffuse THAD of the liver and other CT features indicates acute hepatic injury in patients with viral hepatitis who have no clinical evidence of cirrhosis.

The results of this study show that the presence of a diffuse pattern of THAD indicates acute hepatic injury in patients with viral hepatitis who have no clinical evidence of cirrhosis.

Kim, S, Kim, S, Shin, H, Kim, I, CT Features of Acute Hepatic Injury in Patients with Viral Hepatitis: Focusing on the Presence of Transient Hepatic Attenuation Differences.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009912.html