Budd-Chiari syndrome: an update on imaging features

Budd-Chiari syndrome: imaging review

“…Imaging features are mainly determined by the duration of disease, the number of hepatic veins (HVs) involved, and the degree of obstruction. [13][14][15][16][17] The imaging features of different stages of BCS are illustrated in Figures 1-8.…”

“…In the acute form, venous collaterals have not developed and hepatocellular necrosis occurs rapidly. 11,[13][14][15][16][17] The liver becomes non-homogeneous with delayed enhancement of periphery. The peripheral zones of the liver usually appear hypodense on contrast enhanced CT and hypointense on contrast-enhanced MRI in the arterial phase, which results from the increased post-sinusoidal pressure produced by hepatic venous obstruction.…”

“…14,15 The caudate lobe enlargement is seen in 80-91% of all cases. 16,17 Vascular changes A recent thrombus is hypoechoic on ultrasound and leads to expansion of the lumen of the involved HVs. 17 It produces signal void on Doppler ultrasound.…”

“…16,17 Vascular changes A recent thrombus is hypoechoic on ultrasound and leads to expansion of the lumen of the involved HVs. 17 It produces signal void on Doppler ultrasound. Over a few days, the thrombus becomes echogenic with retraction of the lumen of the involved hepatic veins.…”

“…Over a few days, the thrombus becomes echogenic with retraction of the lumen of the involved hepatic veins. 17,21 On CT and MRI, filling defect is seen within the HVs seen as hypodensity (on CT) or hypointensity (on MRI). [21][22][23] Stenosis is best detected with Doppler ultrasound as it allows interrogation of the hemodynamic effects of the stenosis in the form of color aliasing and a local increase in flow velocity.…”