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Computed tomography angiography manifestations of collateral circulations in Budd-Chiari syndrome

Shi-Feng Cai1, Yong-Hao Gai2, Qing-Wei Liu1

  • 1Department of Radiology, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China.

Experimental and Therapeutic Medicine
|January 10, 2015
PubMed

Insights

Computed tomography angiography (CTA) effectively visualizes collateral circulation in Budd-Chiari syndrome (BCS) patients. This imaging technique reveals both intrahepatic and extrahepatic pathways, aiding in treatment planning for BCS.

Area of Science:

  • Medical Imaging
  • Radiology
  • Vascular Diseases

Background:

  • Budd-Chiari syndrome (BCS) is a rare condition characterized by obstruction of hepatic venous outflow.
  • Collateral circulation is a critical compensatory mechanism in BCS, but its detailed imaging manifestations require assessment.

Purpose of the Study:

  • To evaluate the computed tomography angiography (CTA) findings of collateral circulations in patients diagnosed with Budd-Chiari syndrome (BCS).
  • To classify and describe the various intrahepatic and extrahepatic collateral pathways visualized by CTA in BCS.

Main Methods:

  • Eighty patients with BCS underwent computed tomography (CT) scans.
  • CTA images were utilized to reconstruct collateral circulations involving hepatic veins (HVs) and inferior venae cavae (IVCs).
  • Collateral pathways were categorized into intrahepatic, extrahepatic, and portosystemic types.

Main Results:

  • Collateral circulations were identified in all 80 BCS patients, alongside obstructed HVs and IVCs.
  • Six types of intrahepatic collateral pathways were detailed, with HV-accessory HV being the most common (63.8%).
  • Multiple types of extrahepatic collateral pathways were observed, including IVC-lumbar-ascending lumbar-hemiazygos/azygos vein (100.0%) and IVC-left renal-ascending lumbar-hemiazygos vein (93.8%).

Conclusions:

  • CTA is a valuable tool for demonstrating both intrahepatic and extrahepatic collateral circulations in patients with Budd-Chiari syndrome.
  • The detailed visualization of these collateral pathways by CTA can significantly assist in planning therapeutic interventions for BCS.

Keywords:
Budd-Chiari syndromecollateral circulationcomputed tomography angiography

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