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[Radiological exploration of the Budd-Chiari syndrome. Study of 13 cases]
Insights
Radiological investigation of Budd-Chiari syndrome aids diagnosis. Hepatic phlebography confirms hepatic venous thrombosis, while arteriography helps identify portal flow issues and potential causes.
Area of Science:
- Radiology
- Vascular Medicine
- Gastroenterology
Background:
- Budd-Chiari syndrome is a rare condition characterized by hepatic venous outflow obstruction.
- Accurate diagnosis is crucial for timely intervention and management.
- Radiological imaging plays a pivotal role in diagnosing this complex condition.
Purpose of the Study:
- To describe a systematic radiological investigation method for Budd-Chiari syndrome.
- To highlight the diagnostic utility of various imaging modalities.
- To establish a pathway for etiological diagnosis.
Main Methods:
- Retrospective analysis of 13 Budd-Chiari syndrome cases.
- Detailed description of hepatic phlebography for confirming thrombosis.
- Evaluation of cavography for inferior vena cava assessment.
- Assessment of coeliac and superior mesenteric arteriography for portal flow dynamics.
Main Results:
- Hepatic phlebography is definitive for confirming hepatic venous thrombosis.
- Cavography provides presumptive evidence and can reveal inferior vena cava thrombosis.
- Arteriography is valuable for detecting portal flow inversion and assessing the portal trunk.
- Arteriography can suggest the diagnosis and aid in identifying etiological factors.
Conclusions:
- A structured radiological approach is essential for diagnosing Budd-Chiari syndrome.
- Hepatic phlebography is the gold standard for confirming hepatic venous thrombosis.
- Combined imaging modalities facilitate etiological diagnosis and guide management strategies.
Abstract:
Using 13 cases of Budd-Chiari syndrome, the authors describe their method of radiological investigation in order to reach a positive and sometimes aetiological diagnosis. Hepatic venous thrombosis can be confirmed only on the basis of findings at hepatic phlebography. Cavography, which precedes retrograde catheterisation of the hepatic veins, provides only presumptive evidence and sometimes reveals total thrombosis of the inferior vena cava. Coeliac and superior mesenteric, or even hyperselective hepatic arteriography, is of great value if there is inversion of the portal flow. Otherwise it only leads to a suspicion of the diagnosis, and makes it possible to determine the state of the portal trunk and to seek an aetiology.