Magnetic resonance imaging of 24 cases of Budd-Chiari syndrome with hepatic venous obstruction

Objective: To investigate the value of MRI for diagnosing Budd-Chiari Syndrome (BCS) with hepatic venous (HV) obstruction. Methods: MRI of 24 patients with hepatic venous obstruction confirmed by digital subtraction angiography (DSA) was reviewed. Results: Of 24 patients, proximal HV or accessory hepatic venous (AHV) obstruction was found in 19 (79.2%) including membranous obstruction (12) and segmental obstruction (7). HV was not well seen in the remaining 5 patients (20.8%). Thrombus was detected in HV or collateral vein in 6 patients (25.0%), of whom 4 were fresh and 2 were chronic thrombi. Indirect signs included caudate lobe hypertrophy (17, 70.8%), heterogeneous enhancement of the liver (16, 66.7%), AHV dilatation (9, 37.5%), intrahepatic collaterals (20, 83.3%), extrahepatic collaterals (15, 62.5%), and regenerating nodules (3, 12.5%). Conclusions: BCS with HV obstruction can been accurately diagnosed on MRI, which displays clearly the vascular lesions, collaterals and liver parenchyma lesions. (authors)