Skip to main content

Comparative study of MRI manifestations of acute and chronic Budd–Chiari syndrome

Abdominal Imaging volume 40, pages 76–84 (2015)Cite this article

Abstract

Background

Magnetic resonance imaging (MRI) is able to diagnose Budd–Chiari syndrome (BCS) by distinguishing differential imaging features of acute and chronic forms of the disease. However, the characteristic imaging differences are still not clear as previous data were mostly obtained from scattered small samples instead of large comparative study.

Aim

To investigate MRI manifestations of acute and chronic (BCS), and to evaluate the value of MRI for diagnosis of acute and chronic BCS.

Methods and results

We retrospectively compared MRI results of 24 patients with acute and 82 patients with chronic BCS using Mann–Whitney U test for ascites volume, and Fisher’s exact test for intrahepatic venous collaterals and extra-hepatic venous collaterals. In the acute group, MRI findings suggested thrombosis in hepatic vein (HV) in all acute patients and additional inferior vena cava (IVC) thrombosis in 5 patients. In the chronic BCS group, 6 and 15 patients showed solitary obstruction either in the IVC or HV, respectively, while 61 patients showed combined IVC and HV obstruction. More patients with acute BCS presented with ascites accompanied with high signals on T2WI from intravenous obstructive lesions. Further, the average maximal spleen diameter in patients with acute BCS, and the ratio of patients with acute BCS developing intrahepatic venous collaterals and extra-hepatic venous collaterals were also lower compared with chronic BCS. All these differences were statistically significant.

Conclusion

MRI indicates direct and indirect features of BCS, and therefore enables accurate diagnosis of acute and chronic BCS.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Darwish Murad S, Plessier A, Hernandez-Guerra M, et al. (2009) Etiology, management, and outcome of the Budd–Chiari syndrome. Ann Intern Med 151:167–175

    PubMed  Article  Google Scholar 

  2. Valla DC (2009) Primary Budd–Chiari syndrome. J Hepatol 50:195–203

    PubMed  Article  Google Scholar 

  3. Plessier A, Valla DC (2008) Budd–Chiari syndrome. Semin Liver Dis 28:259–269

    PubMed  Article  Google Scholar 

  4. Singh V, Sinha SK, Nain CK, et al. (2000) Budd–Chiari syndrome: our experience of 71 patients. J Gastroenterol Hepatol 15:550–554

    CAS  PubMed  Article  Google Scholar 

  5. Darwish Murad S, Valla DC, de Groen PC, et al. (2004) Determinants of survival and the effect of portosystemic shunting in patients with Budd–Chiari syndrome. Hepatology 39:500–508

    PubMed  Article  Google Scholar 

  6. Rajani R, Melin T, Björnsson E, et al. (2009) Budd–Chiari syndrome in Sweden: epidemiology, clinical characteristics and survival—an 18-year experience. Liver Int 29:253–259

    PubMed  Article  Google Scholar 

  7. Shrestha SM, Okuda K, Uchida T, et al. (1996) Endemicity and clinical picture of liver disease due to obstruction of the hepatic portion of the inferior vena cava in Nepal. J Gastroenterol Hepatol 11:170–179

    CAS  PubMed  Article  Google Scholar 

  8. Okuda H, Yamagata H, Obata H, et al. (1995) Epidemiological and clinical features of Budd–Chiari syndrome in Japan. J Hepatol 22:1–9

    CAS  PubMed  Article  Google Scholar 

  9. Cheng D, Xu H, Lu ZJ, et al. (2013) Clinical features and etiology of Budd–Chiari syndrome in Chinese patients: a single-center study. J Gastroenterol Hepatol 28:1061–1067

    CAS  PubMed  Article  Google Scholar 

  10. Lupescu IG, Dobromir C, Popa GA, Gheorghe L, Georgescu SA (2008) Spiral computed tomography and magnetic resonance angiography evaluation in Budd–Chiari syndrome. J Gastrointestin Liver Dis 17:223–226

    PubMed  Google Scholar 

  11. Noone TC, Semelka RC, Siegelman ES, et al. (2000) Budd–Chiari syndrome: spectrum of appearances of acute, subacute, and chronic disease with magnetic resonance imaging. J Magn Reson Imaging 11:44–50

    CAS  PubMed  Article  Google Scholar 

  12. Soyer P, Rabenandrasana A, Barge J, et al. (1994) MRI of Budd–Chiari syndrome. Abdom Imaging 19:325–329

    CAS  PubMed  Google Scholar 

  13. Kamath PS (2006) Budd–Chiari syndrome: radiologic findings. Liver Transpl 12:S21–S22

    PubMed  Article  Google Scholar 

  14. Li L-S (2007) Comment on definition and classification of Budd–Chiari syndrome. J Intervent Radiol 16:75–78 ((in Chinese))

    Google Scholar 

  15. Mo Y-F, Zhang X-L, Zhang L-J, Li X-L, Hu B-S (2007) MRI of portal vein and superior mesenteric veilons thrombosis with intestinal ischemia. Chin J Radiol 41:180–183 ((in Chinese))

    Google Scholar 

  16. Erden A, Erden I, Karayalçin S, Yurdaydin C (2002) Budd–Chiari syndrome: evaluation with multiphase contrast-enhanced three-dimensional MR angiography. AJR Am J Roentgenol 179:1287–1292

    PubMed  Article  Google Scholar 

  17. Brancatelli G, Federle MP, Grazioli L, Golfieri R, Lencioni R (2002) Large regenerative nodules in Budd–Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinicopathologic correlation. AJR Am J Roentgenol 178:877–883

    PubMed  Article  Google Scholar 

  18. Valla DC (2003) The diagnosis and management of the Budd–Chiari syndrome: consensus and controversies. Hepatology 38:793–803

    PubMed  Article  Google Scholar 

  19. Buckley O, O’ Brien J, Snow A, et al. (2007) Imaging of Budd–Chiari syndrome. Eur Radiol 17:2071–2078

    CAS  PubMed  Article  Google Scholar 

  20. Langlet P, Escolano S, Valla DC, et al. (2003) Clinicopathological forms and prognostic index in Budd–Chiari syndrome. J Hepatol 39:496–501

    PubMed  Article  Google Scholar 

  21. Noone TC, Semelka RC, Woosley JT, et al. (1996) Ultrasound and MRI findings in acute Budd–Chiari syndrome with histopathologic correlation. J Comput Assist Tomogr 20:819–822

    CAS  PubMed  Article  Google Scholar 

  22. Vilgrain V, Lewin M, Vons C, et al. (1999) Hepatic nodules in Budd–Chiari syndrome: imaging features. Radiology 210:443–450

    CAS  PubMed  Article  Google Scholar 

  23. Flor N, Zuin M, Brovelli F, et al. (2010) Regenerative nodules in patients with chronic Budd–Chiari syndrome: a longitudinal study using multiphase contrast-enhanced multidetector CT. Eur J Radiol 73:588–593

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Radiology, Anhui Provincial Hospital, Hefei, China

    Delei Cheng & Weifei Lv

  2. Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical College, 99 West Huai-hai Road, Xuzhou, 221002, Jiangsu, China

    Hao Xu & Qingqiao Zhang

  3. Department of Radiology, Xuzhou Central Hospital, Xuzhou, China

    Rong Hua & Hongtao Du

  4. Department of Radiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, China

    Kai Xu & Xin Lu

Authors
  1. Delei Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hao Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rong Hua
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kai Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Weifei Lv
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xin Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hongtao Du
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Qingqiao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hao Xu.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cheng, D., Xu, H., Hua, R. et al. Comparative study of MRI manifestations of acute and chronic Budd–Chiari syndrome. Abdom Imaging 40, 76–84 (2015). https://doi.org/10.1007/s00261-014-0193-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-014-0193-y

Keywords

  • Budd–Chiari syndrome
  • Magnetic resonance imaging
  • Acute
  • Chronic
  • Hepatic vein thrombosis