Budd-Chiari syndrome: evaluation with multiphase dynamic contrast-enhanced MR and revascularization
HAN Dong-ming1, CHENG Jing-liang2, LI Yu-xia1, WANG Hong-po1
1. Department of Radiology, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang Henan 453100, China;2. MR Room, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, China
Abstract：Objective: To analyze the images of the Budd-Chiari syndrome(BCS) by multiphase dynamic contrast-enhanced MR and evaluate the clinical value of three-dimensional dynamic contrast-enhanced MR angiography(3D DCE MRA). Materials and Methods: Thirty-three patients with BCS underwent multiphase dynamic contrast-enhanced MR examinations. The relevant vessels were reconstructed respectively with MIP and MPR, i.e. 3D DCE MRA. Compared with the findings of surgery or DSA, we estimated the value of multiphase dynamic contrast-enhanced MR examinations and their revascularization in judging the obstruction level and showing intra/extra-hepatic collateral vessels. Results: Multiphase dynamic contrast-enhanced MR examinations of 33 patients with BCS demonstrated narrowed IVC in 21, obstructed IVC in 12, narrowed or obstructed HV in 15, enlarged accessory hepatic veins in 10, intrahepatic or extrahepatic collateral vessels in 23. The information of vessels and collateral pathways could be showed with MIP reconstruction, and MPR could directly display vessels by multiangles. Liver parenchymal abnormalities displayed by multiphase dynamic contrast-enhanced MR examination showed irregularities of liver contours and hypertrophy of the caudate lobe in 11 cases, heterogeneous patchy enhancement in 25 cases and complicated benign regenerative nodules in 7 cases. Conclusion: Multiphase dynamic contrast-enhanced MR examination can correctly reflect the hepatic hemodynamic changes in patients with BCS, and combined with 3D DCE MRA, can explicitly display the obstruction level of vascular lesions and collateral circulations in BCS. So, it is an effective, noninvasive method for evaluating BCS before surgery or intervention.
2006, Vol. 17 
