Imaging features of hepatic sinusoidal obstruction syndrome or veno-occlusive disease in children

Abstract

Hepatic sinusoidal obstruction syndrome, also known as veno-occlusive disease, can occur as a complication of myeloablative chemotherapy, as a result of low-intensity chemotherapy-related liver toxicity or radiotherapy of the liver. Symptoms of sinusoidal obstruction syndrome can range from asymptomatic to liver dysfunction or severe disease with life-threatening acute multi-organ failure. Imaging features can suggest or support this clinical diagnosis. Familiarity with the imaging spectrum of sinusoidal obstruction syndrome is therefore important for both radiologists and clinical oncologists. Here, multi-modality radiologic appearances of sinusoidal obstruction syndrome in pediatric patients are illustrated, including outcome after follow-up.

Shear wave elastography and dispersion imaging for hepatic veno-occlusive disease prediction after pediatric hematopoietic stem cell transplantation: a feasibility study

“…Several imaging modalities combining grayscale, color Doppler, and elastography-derived quantified US information can aid early detection, treatment evaluation, and follow-up in pediatric veno-occlusive disease [ 12 ]. Quantitative elastography techniques include transient elastography and acoustic radiation force impulse techniques, including point shear wave elastography (SWE) and two-dimensional SWE [ 13 ].…”

Comparison of the different imaging modalities used to image pediatric oncology patients: A COG diagnostic imaging committee/SPR oncology committee white paper

“…As ultrasound can be brought to the patient's bedside, it is particularly useful for critically ill or isolated can be used to monitor the progression or improvement of disease. 22 As important as ultrasound's role in "ruling in" a diagnosis is its ability to exclude abnormalities. Cancer therapies can produce hepatic and renal dysfunction, and ultrasound can demonstrate that biliary and renal collecting systems are not dilated and that hepatic and renal blood flow is normal and, thus, avoid unnecessary interventions or changes in treatment regimens.…”

“…Small and microvascular thrombotic complications include sinusoidal obstruction syndrome (veno‐occlusive disease) of the liver that may complicate bone marrow transplantation. Although the clinical scenario and presentation are usually suggestive of the diagnosis, Doppler ultrasound can confirm by showing characteristic changes in hepatic vascular waveforms and can be used to monitor the progression or improvement of disease 22 . As important as ultrasound's role in “ruling in” a diagnosis is its ability to exclude abnormalities.…”