The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma
A feared complication to liver trauma is delayed vascular complication, such as pseudoaneurysm and arteriovenous fistula (PS/AF) seen as focal enhancement on contrast-enhanced computed tomography (CT) in the arterial phase. A hyperdense area termed transient hepatic attenuation difference (THAD) r...
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| Format: | Article |
| Language: | English |
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MDPI AG
2014-09-01
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| Series: | Diagnostics |
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| Online Access: | http://www.mdpi.com/2075-4418/4/3/129 |
| _version_ | 1811279764178075648 |
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| author | Andreas Hjelm Brandt Caroline Ewertsen Kristoffer Lindskov Hansen |
| author_facet | Andreas Hjelm Brandt Caroline Ewertsen Kristoffer Lindskov Hansen |
| author_sort | Andreas Hjelm Brandt |
| collection | DOAJ |
| description | A feared complication to liver trauma is delayed vascular complication, such as pseudoaneurysm and arteriovenous fistula (PS/AF) seen as focal enhancement on contrast-enhanced computed tomography (CT) in the arterial phase. A hyperdense area termed transient hepatic attenuation difference (THAD) representing altered hepatic blood flow can be seen in the arterial phase near the liver lesion. The objective of this study was to describe THAD and PS/AF on follow-up CT after blunt liver trauma, and to evaluate if THAD influenced the evaluation of PS/AF. Three radiology residents retrospectively evaluated scans of 78 patients. The gold standard for PS/AF was an evaluation by an experienced senior radiologist, while THAD was a consensus between the residents. PS/AF was present in 14% and THAD in 54%. THAD was located in the periphery of the lesion with hazy borders and mean HU levels of 100, while PS/AF was located within the lesion with focal enhancement and mean HU levels of 170 (p < 0.05). In evaluation of PS/AF, the likelihood of agreement between the observers and the gold standard was 89% when THAD was present, and 98% when THAD was absent (p = 0.04). THAD is common and can hamper the evaluation of PS/AF. |
| first_indexed | 2024-04-13T01:01:40Z |
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| id | doaj.art-04ffeaa09c314e31b2a9b9a377e7b929 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-13T01:01:40Z |
| publishDate | 2014-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-04ffeaa09c314e31b2a9b9a377e7b9292022-12-22T03:09:27ZengMDPI AGDiagnostics2075-44182014-09-014312913910.3390/diagnostics4030129diagnostics4030129The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver TraumaAndreas Hjelm Brandt0Caroline Ewertsen1Kristoffer Lindskov Hansen2Department of Radiology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 København Ø, DenmarkDepartment of Radiology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 København Ø, DenmarkDepartment of Radiology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 København Ø, DenmarkA feared complication to liver trauma is delayed vascular complication, such as pseudoaneurysm and arteriovenous fistula (PS/AF) seen as focal enhancement on contrast-enhanced computed tomography (CT) in the arterial phase. A hyperdense area termed transient hepatic attenuation difference (THAD) representing altered hepatic blood flow can be seen in the arterial phase near the liver lesion. The objective of this study was to describe THAD and PS/AF on follow-up CT after blunt liver trauma, and to evaluate if THAD influenced the evaluation of PS/AF. Three radiology residents retrospectively evaluated scans of 78 patients. The gold standard for PS/AF was an evaluation by an experienced senior radiologist, while THAD was a consensus between the residents. PS/AF was present in 14% and THAD in 54%. THAD was located in the periphery of the lesion with hazy borders and mean HU levels of 100, while PS/AF was located within the lesion with focal enhancement and mean HU levels of 170 (p < 0.05). In evaluation of PS/AF, the likelihood of agreement between the observers and the gold standard was 89% when THAD was present, and 98% when THAD was absent (p = 0.04). THAD is common and can hamper the evaluation of PS/AF.http://www.mdpi.com/2075-4418/4/3/129abdomenCTlivertraumavascular injury |
| spellingShingle | Andreas Hjelm Brandt Caroline Ewertsen Kristoffer Lindskov Hansen The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma Diagnostics abdomen CT liver trauma vascular injury |
| title | The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma |
| title_full | The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma |
| title_fullStr | The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma |
| title_full_unstemmed | The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma |
| title_short | The Impact of Transient Hepatic Attenuation Differences in the Diagnosis of Pseudoaneurysm and Arteriovenous Fistula on Follow-Up CT Scans after Blunt Liver Trauma |
| title_sort | impact of transient hepatic attenuation differences in the diagnosis of pseudoaneurysm and arteriovenous fistula on follow up ct scans after blunt liver trauma |
| topic | abdomen CT liver trauma vascular injury |
| url | http://www.mdpi.com/2075-4418/4/3/129 |
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