Transient Arterial Enhancement of the Hepatic Parenchyma in Patients With Acute Cholangitis

Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young

doi:10.1097/rct.0b013e318186faa1

Cited by 19 publications

(28 citation statements)

References 25 publications

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“…In these studies, the THADs appeared as irregular and inhomogeneous forms with various morphological patterns. The clinical significance of THADs in patients with acute cholangitis has been reported in a previous study [9]; the extent of THADs observed in patients with suspected biliary disease was found to have a positive correlation with the white blood cell count and Creactive protein; that is, the THADs could provide information on a biliary infection.…”

Section: Discussionmentioning

confidence: 95%

“…Identification of a bile infection itself by imaging modalities was thought to be impossible [4]. However, attempts to visualise a bile infection have been reported [7,9]. THADs can frequently occur on dynamic CT scans and have been associated with various pathological conditions involving the liver [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Using the method introduced by Kim et al [9], the extent of the THAD was scored by counting the liver segments involved (Couinaud's numbering system, segments I-VIII) regardless of the individual morphology on the following five-point scale ( Table 3). The extent of the THAD was evaluated on late arterial phase images with the soft-tissue setting of both a narrow window width and window level (200 HU and 120 HU, respectively).…”

Section: Image Analysismentioning

confidence: 99%

“…Transient hepatic attenuation differences (THADs), which appear as focal or diffuse hyperdense areas during the hepatic arterial phase on the CT, have been reported to be common in patients with acute cholangitis [7][8][9]. The incidence of THADs in patients with acute cholangitis has ranged from 71% to 98%.…”

mentioning

confidence: 99%

“…The incidence of THADs in patients with acute cholangitis has ranged from 71% to 98%. In addition, one study reported that the THADs observed in patients with suspected biliary disease correlated with the clinical parameters of inflammation [9]. Therefore, we developed a new scoring method for the diagnosis of acute cholangitis using dynamic contrastenhanced MDCT.…”

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confidence: 99%

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Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Kim¹,

Shin²,

Kim³

et al. 2012

BJR

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Objective: The aim of this study was to retrospectively assess the diagnostic performance of multidetector CT (MDCT) for the diagnosis of acute cholangitis using a new scoring method. Methods: Of 80 patients with suspected biliary disease who underwent biphasic CT and endoscopic retrograde cholangiography, 39 were diagnosed as having acute cholangitis (Group 1) and 41 patients were classified as suspected biliary disease (Group 2). 100 agematched patients without evidence of biliary disease were selected randomly as a control group (Group 3). Each patient's axial scan was scored by two independent radiologists for the extent of transient hepatic attenuation difference, the presence of biliary dilatation and identification of a biliary obstructive lesion. The difference in the scores among the three groups was evaluated and the optimal cut-off score for the diagnosis of acute cholangitis was determined. Interobserver agreement was also evaluated. Results: The total scores (mean¡standard deviation) for Groups 1, 2 and 3 were 7.0¡2.0, 4.4¡2.4 and 0.9¡1.2, respectively, for Reviewer 1 and 7.2¡2.7 and 0.7¡1.1, respectively, for Reviewer 2. Significant differences were found for the subscores and the total scores among the three groups (p,0.001). Using a cut-off score of $5, the sensitivity and specificity for diagnosing acute cholangitis were 84.6% and 83.7%, respectively, for Reviewer 1 and 89.7% and 83.7%, respectively, for Reviewer 2. Agreement for the subscores between readers was good to excellent (k50.74-0.86). Conclusion: Based on dynamic MDCT and the described CT scoring method, the diagnosis of acute choangitis can be made with high sensitivity and specificity.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Kim¹,

Shin²,

Kim³

et al. 2012

BJR

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Diagnostic accuracy of transient hepatic attenuation differences on computed tomography scans for acute cholangitis in patients with malignant disease

Sugishita

Higuchi

Morita

et al. 2014

J Hepato Biliary Pancreat

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A multi‐institutional study designed by members of Tokyo Guidelines (TG) Core Meeting to elucidate the clinical characteristics and pathogenesis of acute cholangitis after bilioenteric anastomosis and biliary stent insertion with a focus on biliary obstruction: Role of transient hepatic attenuation difference (THAD) and pneumobilia in improving TG diagnostic performance

Kato,

Takada,

Strasberg

et al. 2023

J Hepato Biliary Pancreat

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Background/PurposeThe aim of this study was to clarify the clinical characteristics of acute cholangitis (AC) after bilioenteric anastomosis and stent‐related AC in a multi‐institutional retrospective study, and validate the TG18 diagnostic performance for various type of cholangitis.MethodsWe retrospectively reviewed 1079 AC patients during 2020, at 16 Tokyo Guidelines 18 (TG 18) Core Meeting institutions. Of these, the post‐biliary reconstruction associated AC (PBR‐AC), stent‐associated AC (S‐AC) and common AC (C‐AC) were 228, 307, and 544, respectively. The characteristics of each AC were compared, and the TG18 diagnostic performance of each was evaluated.ResultsThe PBR‐AC group showed significantly milder biliary stasis compared to the C‐AC group. Using TG18 criteria, definitive diagnosis rate in the PBR‐AC group was significantly lower than that in the C‐AC group (59.6% vs. 79.6%, p < .001) because of significantly lower prevalence of TG 18 imaging findings and milder bile stasis. In the S‐AC group, the bile stasis was also milder, but definitive‐diagnostic rate was significantly higher (95.1%) compared to the C‐AC group. The incidence of transient hepatic attenuation difference (THAD) and pneumobilia were more frequent in PBR‐AC than that in C‐AC. The definitive‐diagnostic rate of PBR‐AC (59.6%–78.1%) and total cohort (79.6%–85.3%) were significantly improved when newly adding these items to TG18 diagnostic imaging findings.ConclusionsThe diagnostic rate of PBR‐AC using TG18 is low, but adding THAD and pneumobilia to TG imaging criteria may improve TG diagnostic performance.

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Transient Arterial Enhancement of the Hepatic Parenchyma in Patients With Acute Cholangitis

Cited by 19 publications

References 25 publications

Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Diagnostic accuracy of transient hepatic attenuation differences on computed tomography scans for acute cholangitis in patients with malignant disease

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