Venocclusive disease of the liver: prospective study of US evaluation

Twenty-one bone marrow transplantation (BMT) patients were studied prospectively to determine the prevalence of sonographic hepatobiliary abnormalities and to determine if these abnormalities were associated with hepatic venocclusive disease (VOD). Baseline US was performed in all patients prior to chemoradiation therapy, with follow-up ultrasound (US) examinations at the time of BMT and 14 days and 28 days after BMT. Sonograms were reviewed for the presence of ascites, gallbladder wall thickening, hepatosplenomegaly, hepatofugal flow, hepatic vein compression, increased periportal echogenicity, and increased hepatic echotexture. The baseline scans showed 13 of 21 patients (62%) with abnormalities prior to BMT. Within 2 weeks after BMT, serial US showed interval development of hepatomegaly in five patients (three with VOD and two without), gallbladder wall thickening in one (with VOD), hepatic vein compression in two (both with VOD), hepatofugal flow in one (without VOD), and ascites in one (with VOD). US scans obtained 4 weeks after BMT in 15 of the 21 patients showed even fewer new abnormalities. No sonographic finding was strongly associated with VOD.