Primary Budd-Chiari Syndrome: Diagnostic Significance of Intrahepatic Collaterals on Color Doppler Sonography
El-Sharkawy MS 1 and EL-Ghannam M 2
1Radiology and medical imaging Department, King Khalid University Hospital,king Saud University,Riyadh, Saudi Arabia; 2 Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt. firstname.lastname@example.org
Abstract: Purpose: is to analyze the frequency of intrahepatic collaterals in primary Budd-Chiari Syndrome (BCS) on color Doppler ultrasound and asses its diagnostic significance compared to other sono-morphological signs. Patients and methods: Doppler findings in 23 diagnosed primary BCS patients (examined between 2005-2010) retrospectively reviewed. Diagnosed by clinical/laboratory data as primary BCS. CT confirmed Diagnosis (n=20).MRI confirmed remaining 3 pregnant patients. Doppler evaluation for hepatic veins, intrahepatic collaterals, IVC patency, portal & hepatic veins. Results: Using Doppler, intrahepatic collaterals seen in 21 of 23 (91.3%). Subcapsular collaterals alone in 7 (30.4%), Portovenous intrahepatic collaterals alone in 2 (8.69%), both combined in 12 patients (52.17%). Absence of hepatic veins/artery abnormal flow confirmed Veno-venous nature excluding arterio-portal and arterio-venous collaterals. Intrahepatic collaterals detected on CT in 17/20 (85%). Difference of venovenous collaterals detectability in primary BCS (without sub-typing) by US (91.3%) compared to CT (85%) was nonspecific as P. value was P>0.05. Conclusion: The non-invasive US / CDS has high detection rate of diagnostic signs in primary BCS. Highest significance of intrahepatic collaterals (particularly subcapsullar veno-venous) on CDS is significantly unique. This importance is more significant as CDS/US is the initial modality primary BCS.
[El-Sharkawy M. S and EL-Ghannam M. Primary Budd-Chiari Syndrome: Diagnostic Significance of Intrahepatic Collaterals on Color Doppler Sonography. J Am Sci 2012;8(10):795-800]. (ISSN: 1545-1003).http://www.jofamericanscience.org. 107
Keywords: Budd-Chiari, Doppler ultrasound, liver, intrahepatic collaterals. Full Text 107