title: Hepatic and pancreatic involvement in hereditary hemorrhagic telangiectasia: quantitative and qualitative evaluation with 64-section CT in asymptomatic adult patients.
abstract: OBJECTIVE
  To analyse quantitatively and qualitatively asymptomatic hepatic and pancreatic involvement in hereditary haemorrhagic telangiectasia (HHT) using 64-section helical CT.
  
  
  METHODS
  The 64-section helical CT examinations of 19 patients with HHT (8 men, 11 women; mean age, 58.6 years) were quantitatively and qualitatively analysed and compared to those of 19 control subjects who were matched for age and sex. Comparisons were made using univariate analysis.
  
  
  RESULTS
  Dilated and tortuous intrahepatic arterial branches was the most discriminating independent variable (P < 0.0001) and had the highest specificity (100%; 19/19; 95%CI: 82%-100%) and accuracy (97%; 37/38; 95%CI: 86%-100%) for the diagnosis of HHT. Heterogeneous enhancement of hepatic parenchyma, intrahepatic telangiectases, hepatic artery to hepatic vein shunting, hepatic artery enlargement (i.e. diameter > 6.5 mm) and portal vein enlargement (i.e. diameter > 13 mm) were other variables that strongly correlated with the presence of HHT. Intrapancreatic telangiectases and arteriovenous malformations were found in 42% and 16% of patients with HHT, respectively.
  
  
  CONCLUSIONS
  Liver and pancreatic involvement in asymptomatic HHT patients is associated with myriad suggestive findings on 64-section helical CT. It can be anticipated that familiarity with these findings would result in more confident diagnosis of HHT.
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2 rue Ambroise Paré, 75475, Paris cedex 10, France. matthias_barral@yahoo.fr
authors.forename: Matthias
authors.initials: M
authors.lastname: Barral
authors.forename: Marc
authors.initials: M
authors.lastname: Sirol
authors.forename: Vinciane
authors.initials: V
authors.lastname: Placé
authors.forename: Lounis
authors.initials: L
authors.lastname: Hamzi
authors.forename: Michel
authors.initials: M
authors.lastname: Borsik
authors.forename: Etienne
authors.initials: E
authors.lastname: Gayat
authors.forename: Mourad
authors.initials: M
authors.lastname: Boudiaf
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001165:Arteriovenous Malformations / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000473:pathology; D036301:Qualitative Research; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods