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Transient hepatic intensity differences

Transient hepatic intensity differences (THID)'s are a phenomenon observed on hepatobiliary MRI imaging. They are considered a direct equivalent to transient hepatic attenuation differences (THAD)'s noted on CT. They may be focal or non focal.

Pathology

Focal lesions

A focal THID lesion can arise from four pathological mechanisms

  • directly by a siphoning effect (lobar multisegmental shape)
  • indirectly by means of portal hypoperfusion (sectorial shape) due to portal branch compression or infiltration
  • by thrombosis resulting in a portal branch blockade
  • by flow diversion caused by an arterioportal shunt
Non focal lesions

These can be diffuse, polymorphous or diffuse and can arise from varying aetiology

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