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Intersegmental attenuation difference on CT caused by partial Budd-Chiari syndrome secondary to hepatocellular
K Takayasu1, Y Muramatsu, H Furukawa
1Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
Insights
Dynamic CT aids in diagnosing partial Budd-Chiari syndrome in hepatocellular carcinoma patients. Recognizing intersegmental density differences on CT is key for identifying this condition.
Area of Science:
- Radiology
- Hepatology
- Oncology
Background:
- Partial Budd-Chiari syndrome can be secondary to hepatocellular carcinoma.
- Accurate diagnosis is crucial for patient management.
Observation:
- Dynamic CT was used to evaluate two patients with partial Budd-Chiari syndrome and hepatocellular carcinoma.
- Obstruction involved middle and left hepatic veins in one patient, and the right hepatic vein in another.
- CT revealed distinct density patterns in affected liver segments.
Findings:
- Intersegmental attenuation differences on CT correlated with specific obstructed hepatic veins.
- Low density was observed in unenhanced and contrast-enhanced CT in one case.
- High density was noted on enhanced CT in the other case.
Implications:
- Identifying intersegmental attenuation differences on CT is a valuable indicator for partial Budd-Chiari syndrome.
- This imaging finding can guide further diagnostic and therapeutic strategies.
- Early detection may improve outcomes for patients with liver cancer and venous obstruction.
Abstract:
For two patients with partial Budd-Chiari syndrome secondary to hepatocellular carcinoma, dynamic CT was evaluated. The obstructed hepatic veins were both the middle and left hepatic veins in Case 1 and the right hepatic vein in Case 2. The area affected by obstructed hepatic vein(s) was seen as low density on both unenhanced and contrast enhanced CT in Case 1 and as high density on enhanced CT in Case 2. The border of attenuation differences caused by the obstruction of the middle (Case 1) or right (Case 2) hepatic vein was intersegmental planes of the anterior segment of the right lobe, and that caused by the obstruction of the left hepatic vein was the intersegmental plane of the medial third of the left lateral segment. Once intersegmental attenuation difference is recognized on CT, partial Budd-Chiari syndrome should be considered.