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Sonographic classification of draining pathways of obstructed hepatic veins in Budd-Chiari syndrome

Yong-Hao Gai1, Shi-Feng Cai, Wen-Bin Guo

  • 1Department of Ultrasound, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, China.

Journal of Clinical Ultrasound : JCU
|October 30, 2013
PubMed

Insights

Sonography can classify blood-draining pathways in Budd-Chiari syndrome. This classification of obstructed hepatic veins aids in treatment and follow-up.

Area of Science:

  • Medical Imaging
  • Hepatology
  • Vascular Surgery

Background:

  • Budd-Chiari syndrome involves hepatic vein obstruction.
  • Understanding blood-draining pathways is crucial for patient management.

Purpose of the Study:

  • To propose a sonographic classification for obstructed hepatic vein blood-draining pathways in Budd-Chiari syndrome.
  • To evaluate the utility of ultrasound in visualizing these complex vascular alterations.

Main Methods:

  • Retrospective analysis of 206 patients with hepatic vein obstructions.
  • Sonographic examination assessing hepatic veins, draining veins, and collateral pathways.
  • Comparison of sonographic findings with digital subtraction angiography and CT angiography.

Main Results:

  • 542 out of 618 hepatic veins were obstructed.
  • Classified draining pathways included hepatic vein-accessory hepatic vein, hepatic vein-hepatic vein/accessory hepatic+hepatic vein, and collateral pathways.
  • Draining occurred to the inferior vena cava, right atrium, para-umbilical veins, or hepatic subcapsular veins via communicating branches.

Conclusions:

  • Sonography accurately delineates blood-draining pathways in Budd-Chiari syndrome.
  • This sonographic classification can guide treatment strategies and patient follow-up.
  • Ultrasound is a valuable tool for evaluating complex venous obstructions in the liver.
Abstract

Keywords:
collateral pathwaysduplex and color Doppler ultrasonographyhepatic vein thrombosisultrasonography

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