Comparison of 3.0T MRI with 3D LAVA sequence and digital subtraction angiography for the assessment of accessory hepatic veins in Budd-Chiari syndrome

Lu, Li; Xu, Kai; Han, Cuiping; Xu, Chao; Xu, Huamin; Dai, Yue; Yao, Rong; Li, Shaodong; Xie, Lizhi

doi:10.1002/jmri.25381

Cited by 7 publications

(7 citation statements)

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“…As such, the AHV can be used as an alternative to the HV to facilitate hepatic drainage in individuals diagnosed with BCS. As the AHV is not the primary mediator of hepatic drainage in healthy individuals it is often overlooked, but the hepatic hypertension that develops in individuals with BCS can result in collateral intrahepatic circulation and resultant AHV dilation [25,26].…”

Section: Discussionmentioning

confidence: 99%

Accessory hepatic vein recanalization for Budd-Chiari syndrome: a systematic review and meta-analysis

Liu

et al. 2023

Preprint

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Background Budd-Chiari syndrome (BCS) results when the outflow of the hepatic vein (HV) is obstructed. BCS patients exhibiting an accessory HV (AHV) that is dilated but obstructed can achieve significant alleviation of liver congestion after undergoing AHV recanalization. This meta-analysis was developed to explore the clinical efficacy of AHV recanalization in patients with BCS. Materials and Methods PubMed, Embase, and Wanfang databases were searched for relevant studies published as of November 2022, and RevMan 5.3 and Stata 12.0 were used for pooled endpoint analyses. Results Twelve total studies were identified for analysis. Pooled primary clinical success, re-stenosis, 1- and 5-year primary patency, 1- and 5-year secondary patency, 1-year overall survival (OS), and 5-year OS rates of patients in these studies following AHV recanalization were 96%, 17%, 91%, 75%, 98%, 91%, 97%, and 96%, respectively. Patients also exhibited a significant reduction in AHV pressure after recanalization relative to preoperative levels (P < 0.00001). Endpoints exhibiting significant heterogeneity among these studies included, AHV pressure (I2 = 95%), 1-year primary patency (I2 = 51.2%), and 5-year primary patency (I2 = 62.4%). Relative to HC recanalization, AHV recanalization was related to a lower rate of re-stenosis (P = 0.002) and longer primary patency (P < 0.00001), but was not associated with any improvements in clinical success (P = 0.88) or OS (P = 0.29) relative to HV recanalization. Conclusions The present meta-analysis highlights AHV recanalization as an effective means of achieving positive long-term outcomes in patients affected by BCS, potentially achieving better long-term results than those associated with HV recanalization.

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Section: Discussionmentioning

confidence: 99%

Accessory hepatic vein recanalization for Budd-Chiari syndrome: a systematic review and meta-analysis

Liu

et al. 2023

Preprint

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“…Balloon dilation is the first treatment to be performed, and stent implantation is an adjunctive measure when repeated angiography shows significant residual stenosis after balloon dilation. When the three major hepatic veins are occluded, the AHVs can undergo compensatory expansion [5,15]. Patients with BCS can be asymptomatic when compensatory expansion of the AHV occurs because the expansive AHV can drain blood from the occlusive major hepatic veins through collateral pathways to the IVC [2,8].…”

Section: Discussionmentioning

confidence: 99%

“…They are usually small and include the inferior right hepatic veins and the caudate veins [2,3]. The AHV is common in patients with BCS, having a reported prevalence that ranges from 54.8 to 78.3% [3][4][5]. The prevalence of AHV obstruction has been reported at 21.8% in patients with BCS involving obstruction of three major hepatic veins [6].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of interventional treatment for Budd–Chiari syndrome with chronic accessory hepatic vein obstruction

Zhang

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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Objective Interventional treatment is the main therapy for Budd–Chiari syndrome (BCS) with hepatic vein obstruction. The aim of this study was to investigate the long-term outcomes of endovascular management for BCS with chronic accessory hepatic vein (AHV) obstruction. Methods In total, 68 patients with primary BCS who underwent AHV dilation with or without stenting from January 2008 to December 2018 were included in this retrospective study. The technical success rate and complications were recorded. Cumulative patency rates were estimated by the Kaplan–Meier curves and compared using the log-rank test. Results Technical success was achieved in all 68 patients, and AHV patency was confirmed by postoperative angiography. Fifty-two patients underwent balloon dilation alone and 16 underwent adjunctive stent implantation. During a mean follow-up period of 60.2 ± 30.5 months, AHV reocclusion occurred in 14 patients in the balloon group and four patients in the stent group (χ 2 = 0.034, P = 0.855). The overall cumulative 1-, 3-, 5-, and 7-year primary and secondary AHV patency rates were 90.6, 76.6, 72.0, and 68.2% and 98.4, 91.4, 89.2, and 89.2%, respectively. The cumulative 1-, 3-, 5-, and 7-year primary patency rates of the AHV were 89.8, 73.8, 71.2, and 71.2% in the balloon group and 93.3, 86.2, 75.4, and 60.3% in the stent group, respectively. There was no statistically significant difference between the two groups (P = 0.934). Conclusion Interventional treatment of BCS with chronic AHV obstruction has good long-term outcomes. Both balloon dilation alone and adjunctive stent implantation can be used for AHV recanalization.

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“…AHV in BCS patients as indicated by a retrospective analysis. Lu et al (32) suggested that LAVA sequence is able to detect more AHVs than DSA. In addition, MRA clearly reveals the opening direction of AHV and the angle between AHV and distal vena cava, which have practical value for interventional therapy (33).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of magnetic resonance angiography for Budd‑Chiari syndrome: A meta‑analysis

Lyu

Sami

et al. 2018

Exp Ther Med

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In recent years, the role of magnetic resonance angiography (MRA) in the diagnosis of Budd-Chiari Syndrome (BCS) has been the focus of various clinical studies. The purpose of the present study was to perform a meta-analysis of the diagnostic performance of MRA in patients with BCS by using digital subtraction angiography as a reference method. The search strategy for relevant research articles was based on the Cochrane Handbook for Systematic Reviews, and literature databases (including PubMed, Medline and China National Knowledge Infrastructure) and reference lists of retrieved studies published from 2000 to 2016 were searched. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the methodological quality of these research studies by two reviewers independently. Summary estimates of the sensitivity, specificity, positive/negative likelihood ratio (LR+/-), diagnostic odds ratio (DOR) and the summary receiver operating characteristic (SROC) curve of MRA in identifying BCS were obtained. The pooled MRA estimates had a sensitivity of 97.6% [95% confidence interval (CI), 95.1-99.0%], a specificity of 70.7% (95% CI, 54.5-83.9%), an LR+ of 3.163 (95% CI, 2.03-4.94) and an LR-of 0.045 (95% CI, 0.02-0.09). The overall DOR was 94.053 (95% CI,. The area under the SROC curve was 0.972. In conclusion, MRA is an accurate modality for evaluating BCS. Materials and methodsPublication search. The PubMed (https://www.ncbi. nlm.nih.gov/pubmed/), MEDLINE (https://www.nlm. nih.gov/bsd/pmresources.html), SCOPUS (https://www. scopus.com/home.uri), EMBASE (https://www.elsevier. com/solutions/embase-biomedical-research), Cochrane Library

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Comparison of 3.0T MRI with 3D LAVA sequence and digital subtraction angiography for the assessment of accessory hepatic veins in Budd-Chiari syndrome

Abstract: 4 J. Magn. Reson. Imaging 2017;45:401-409.

Cited by 7 publications

References 30 publications

Accessory hepatic vein recanalization for Budd-Chiari syndrome: a systematic review and meta-analysis

Accessory hepatic vein recanalization for Budd-Chiari syndrome: a systematic review and meta-analysis

Long-term outcomes of interventional treatment for Budd–Chiari syndrome with chronic accessory hepatic vein obstruction

Diagnostic accuracy of magnetic resonance angiography for Budd‑Chiari syndrome: A meta‑analysis

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