Abstract
Background
A transient hepatic attenuation difference (THAD) is a hepatic perfusion anomaly seen on contrast-enhanced CT scans caused by an alteration in the dual blood supply of the liver. Although THADs have been described in adolescents and adults, they have not previously been described in neonates.
Objective
We describe the appearance and evaluate the frequency of THADs in neonates ≤1 month of age compared to other infants younger than 2 years.
Materials and methods
A retrospective study was performed looking at all CT angiograms from 2000 to 2007 in infants <2 years of age. The incidence of THADs was compared among four age groups. Significance was determined using a logistic regression model.
Results
The study included 128 CT angiograms. A THAD was seen in 9/26 infants <1 month of age, in 3/50 infants 1 to 6 months of age, in 1/23 infants 6 months to 1 year of age, and in 1/29 infants 1 to 2 years of age. A THAD was found significantly more frequently in infants <1 month of age than in the older age groups (P<0.05).
Conclusion
THADs are benign entities that can be seen normally in the neonatal age group. When the characteristic appearance is seen on CT, no further imaging is needed.
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References
Colagrande S, Carmignani L, Pagliari A et al (2002) Transient hepatic attenuation differences (THAD) not connected to focal lesions. Radiol Med 104:25–43
Colagrande S, Centi N, La Villa G et al (2004) Transient hepatic attenuation differences. AJR 183:459–464
Köseoğlu K, Taşkin F, Özsunar Y et al (2005) Transient hepatic attenuation differences at biphasic spiral CT examinations. Diagn Interv Radiol 11:96–101
Chen WP, Chen JH, Hwang JI et al (1999) Spectrum of transient hepatic attenuation differences in biphasic helical CT. AJR 172:419–424
Pickhardt PJ, Fleishman MJ, Fisher AJ (2003) Fitz-Hugh-Curtis syndrome: multidetector CT findings of transient hepatic attenuation difference and gallbladder wall thickening. AJR 180:1605–1606
Ito K, Awaya H, Mitchell DG et al (1997) Gallbladder disease: appearance of associated transient increased attenuation in the liver at biphasic, contrast-enhanced dynamic CT. Radiology 204:723–728
Itai Y, Moss AA, Goldberg HI (1982) Transient hepatic attenuation difference of lobar or segmental distribution detected by dynamic computed tomography. Radiology 144:835–839
Schlesinger AE, Braverman RM, DiPietro MA (2003) Pictorial essay. Neonates and umbilical venous catheters: normal appearance, anomalous positions, complications, and potential aid to diagnosis. AJR 180:1147–1153
Yoshimoto Y, Shimizu R, Saeki T et al (2004) Patent ductus venosus in children: a case report and review of the literature. J Pediatr Surg 39:E1–E5
Kiserud T (2001) The ductus venosus. Semin Perinatol 25:11–20
Loberant N, Barak M, Gaitini D et al (1992) Closure of the ductus venosus in neonates: findings on real-time gray-scale, color-flow Doppler, and duplex Doppler sonography. AJR 159:1083–1085
Tchirikov M, Schröder HJ, Hecher K (2006) Ductus venosus shunting in the fetal venous circulation: regulatory mechanisms, diagnostic methods and medical importance. Ultrasound Obstet Gynecol 27:452–461
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Towbin, A.J., Ying, J. & Fleck, R. Transient hepatic attenuation differences in neonates. Pediatr Radiol 39, 798–803 (2009). https://doi.org/10.1007/s00247-009-1273-y
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DOI: https://doi.org/10.1007/s00247-009-1273-y