Imaging of hepatic venocclusive disease

This paper reports hepatic venocclusive disease (VOD) is the leading cause of morbidity and mortality after bone marrow transplantation (BMT). This paper reviews the imaging findings in patients with VOD. The authors retrospectively reviewed 377 patients who had undergone autologous BMT. Twenty-nine patients had either pathologic proof (6/29) or met established clinical (McDonald's) criteria for VOD. Imaging methods used included ultrasound (US) (19), CT (10), and MR imaging in four; all studies were done during acute episode, with an average of 5.6 days from peak bilirubin. US showed ascites in 10/19, gallbladder wall thickening in 11/19 (sludge in 5/19), and periocholecystic fluid in 4/19; hepatomegaly was diagnosed by US in 2/19, increased periportal echogenicity was present in 6/19 and hepatic veins were generally poorly visualized or not imaged