Transient hepatic intensity difference

Last revised by Daniel J Bell on 4 Mar 2024

Transient hepatic intensity differences (THIDs) are a phenomenon observed on MRI imaging of the liver. They are considered a direct equivalent to transient hepatic attenuation differences (THADs) noted on CT. They may be focal or non-focal.

Pathology

Focal THIDs

A focal THID 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 THIDs

These can be sectorial, polymorphous or diffuse and can arise from a variety of etiologies.

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