Budd-Chiari syndrome: a review of imaging findings

Area of Science:

• Medical Imaging
• Hepatology
• Vascular Medicine

Background:

• Budd-Chiari syndrome is an uncommon, potentially fatal disorder caused by obstructed hepatic venous outflow.
• Obstructions occur in hepatic veins, the inferior vena cava, or both, impacting liver function.
• Diagnostic imaging is crucial for visualizing the obstruction's nature, location, and extent.

Purpose of the Study:

• To outline the diagnostic imaging approach for Budd-Chiari syndrome.
• To emphasize the role of various imaging modalities in diagnosis and treatment planning.
• To highlight the importance of early detection for effective management.

Main Methods:

• Gray-scale sonography with color and pulsed Doppler is the initial diagnostic step.
• Contrast-enhanced cross-sectional imaging, preferably MR angiography, follows initial assessment.
• Hepatic venography or venacavography may be performed directly in high-suspicion cases.

Main Results:

• Imaging can display direct evidence of obstruction and indirect findings like collateral veins.
• Altered liver morphology and enhancement patterns support the diagnosis.
• Imaging guides potential recanalization procedures such as angioplasty or TIPS.

Conclusions:

• A stepwise imaging approach, starting with sonography, is effective for diagnosing Budd-Chiari syndrome.
• Advanced imaging like MR angiography and venography are vital for comprehensive evaluation.
• Timely diagnosis through imaging facilitates prompt therapeutic interventions, improving patient outcomes.