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I Had A Diagnosis Of What Was Then Called Chronic
Question: I had a diagnosis of what was then called chronic aggressive hepatitis B in 1978. Was on high dose prednisone and Imuran for many, many months. Now at age 67 although not symptomatic I've had 4 CT scans over a couple of years, plus a fibroscan and all gave the diagnosis of cirrhosis, severe fibrosis. I have now had two MRI, which I understand is the gold standard, which gave a different a different finding of fatty liver with THIDS which increased in number and size during the 4 months between scans. It also shows replaced right hepatic artery from superior mesenteric artery. I know the latter hepatitic artery issue is most likely not relevant but wanted you to have all info. My question pertains to how can several CT scans done over 2 years plus the fibroscan give such an entirely different finding from MRI? What is, if any, the significance of THIDS, and lastly the hepatic artery issue.
Brief Answer:
Pathophysiology explained
Detailed Answer:
Thanks for using the 'Ask A Doctor' service.
I have gone through your query and understand your concerns.
Transient hepatic intensity differences (THIDs) are a phenomenon observed on MRI imaging of the liver.
Such a thing indicates portal hypoperfusion (delayed/decreased blood circulation) which can be due to hepatic artery portal branch compression, infiltration or thrombosis resulting in a portal branch blockade. The liver is a dynamic structure and has thereafter managed a blood supply from an alternative source. That is how the right hepatic artery has been replaced by branches from the superior mesenteric artery.
CT Scans cannot pick up soft tissue changes as good as an MRI. Therefore they are just not comparable.
The dynamicity of the situation has not been picked up by the CT scan and by the time an MRI has been done, significant structural changes were observable.
Feel free to write back.
Regards
Pathophysiology explained
Detailed Answer:
Thanks for using the 'Ask A Doctor' service.
I have gone through your query and understand your concerns.
Transient hepatic intensity differences (THIDs) are a phenomenon observed on MRI imaging of the liver.
Such a thing indicates portal hypoperfusion (delayed/decreased blood circulation) which can be due to hepatic artery portal branch compression, infiltration or thrombosis resulting in a portal branch blockade. The liver is a dynamic structure and has thereafter managed a blood supply from an alternative source. That is how the right hepatic artery has been replaced by branches from the superior mesenteric artery.
CT Scans cannot pick up soft tissue changes as good as an MRI. Therefore they are just not comparable.
The dynamicity of the situation has not been picked up by the CT scan and by the time an MRI has been done, significant structural changes were observable.
Feel free to write back.
Regards
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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