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• W2078135974 abstract "Indian J Gastroenterol 2009: 28(Jan–Feb):3–4 Budd-Chiari syndrome is characterized by hepatic venous outfl ow obstruction, with or without involvement of the inferior vena cava (IVC), and can be due either to venous thrombosis or to membranous occlusion, often leading to chronic liver disease. It is a well known clinical entity in the Far East, the Middle East, India and Africa. 1 The site, extent, and rapidity of hepatic venous occlusion can be highly variable. Information on these aspects of venous obstruction is important for planning appropriate treatment for patients with BCS. Thus, imaging of the hepatic veins and IVC plays a crucial role in the management of patients with BCS. Several non-invasive diagnostic imaging techniques like color Doppler (CD), multidetector computed tomography (MDCT) and, more recently, magnetic resonance imaging (MRI) have all been used in patients with BCS. Because of wide variations in clinical presentations and venous anatomy, and availability of a variety of imaging modalities, patients with BCS need an individualized imaging strategy to obtain a complete evaluation of venous abnormalities and deciding an appropriate treatment plan. Since the clinical condition of patients with BCS can deteriorate rapidly, an early correct diagnosis and evaluation is important. Ultrasonography combined with CD has a diagnostic sensitivity of more than 75% to diagnose venous obstruction. It is also cheap, quick, non-invasive and widely available. Because of these advantages, it is usually the fi rst line of investigation to diagnose hepatic venous outfl ow obstruction in patients with liver disease. 2,3 Normal hepatic veins exhibit characteristic triphasic Doppler signal when patent. Classic fi ndings that suggest involvement of hepatic vein(s) in BCS are non-visualization of the vein(s), replacement of the vein with a fi brous cord-like structure, presence of a thrombus in the vein lumen and venous stenosis at the confl uence of the hepatic vein with the IVC. Demonstration of a caudate lobe vein equal to or larger than 3 mm in diameter is a specifi c sign of BCS, provided the patient does not have heart failure. 4 However, CD evaluation of hepatic veins in a swollen liver in BCS is often diffi cult and inaccurate, because the compressed hepatic veins may not be visible even though these they may be patent. In addition, it is sometimes diffi cult to detect occlusion of the left and middle hepatic veins using CD as cardiac pulsations are in close proximity with the left lobe of the liver. 4 Thus, though CD appears to be a good screening tool in the initial" @default.
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• W2078135974 date "2009-01-01" @default.
• W2078135974 modified "2023-09-26" @default.
• W2078135974 title "MDCT venography in the evaluation of inferior vena cava in Budd-Chiari syndrome: a road less travelled" @default.
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• W2078135974 doi "https://doi.org/10.1007/s12664-009-0002-7" @default.
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