Budd-Chiari syndrome: an update on imaging features

Area of Science:

• Hepatology
• Vascular Medicine
• Radiology

Background:

• Budd-Chiari syndrome (BCS) is a rare condition leading to portal hypertension and liver failure.
• It is defined by impaired hepatic venous drainage, impacting liver function.
• Early diagnosis is crucial for effective treatment initiation.

Purpose of the Study:

• To outline the diagnostic imaging findings in Budd-Chiari syndrome.
• To differentiate between direct and indirect imaging signs indicative of BCS.
• To emphasize the role of imaging in guiding BCS management.

Main Methods:

• Review of imaging findings used in the diagnosis of Budd-Chiari syndrome.
• Categorization of imaging signs into direct and indirect.
• Description of characteristic findings for each category.

Main Results:

• Direct signs include visualization of obstructive lesions in hepatic veins or the inferior vena cava.
• Indirect signs result from venous obstruction and include collateral circulation (intra- and extrahepatic).
• Indirect signs also encompass perfusion abnormalities, liver dysmorphy, and indicators of portal hypertension.

Conclusions:

• Imaging is fundamental for diagnosing Budd-Chiari syndrome.
• Distinguishing between direct and indirect signs aids in comprehensive diagnosis.
• Imaging findings guide the initiation and planning of BCS treatment.