Budd-Chiari syndrome CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]

Overview

CT scan may be helpful in the diagnosis of Budd-Chiari syndrome. Contrast-enhanced computed tomography (CT) is performed in portal venous phase, this helps to obtain good contrast filling in the portal, mesenteric, and hepatic veins and in inferior vena cava for detection of associated pathology. Findings on CT scan suggestive of Budd-Chiari syndrome include early enhancement of the caudate lobe and central liver around the inferior vena cava, delayed enhancement of the peripheral liver with accompanying central low density (flip-flop appearance), inhomogeneous mottled liver (nutmeg liver), peripheral zones of the liver may appear hypo-attenuating because of reversed portal venous blood flow, inability to identify hepatic veins, in the chronic phase, there is caudate lobe enlargement and atrophy of the peripheral liver in affected areas.

CT

CT scan may be helpful in the diagnosis of Budd-Chiari syndrome.^[1]^[2]^[3]
Contrast-enhanced computed tomography (CT) is performed in portal venous phase, this helps to obtain good contrast filling in the portal, mesenteric, and hepatic veins and in inferior vena cava for detection of associated pathology.
Findings on CT scan suggestive of Budd-Chiari syndrome include:
- Early enhancement of the caudate lobe and central liver around the inferior vena cava
- Delayed enhancement of the peripheral liver with accompanying central low density (flip-flop appearance)
- Heterogenous mottled liver (nutmeg liver)
- Peripheral zones of the liver may appear hypo-attenuating because of reversed portal venous blood flow
- Inability to identify hepatic veins
- In the chronic phase, there is caudate lobe enlargement and atrophy of the peripheral liver in affected areas

References

↑ Kim TK, Chung JW, Han JK, Kim AY, Park JH, Choi BI (1999). “Hepatic changes in benign obstruction of the hepatic inferior vena cava: CT findings”. AJR Am J Roentgenol. 173 (5): 1235–42. doi:10.2214/ajr.173.5.10541095. PMID 10541095.
↑ Torabi M, Hosseinzadeh K, Federle MP (2008). “CT of nonneoplastic hepatic vascular and perfusion disorders”. Radiographics. 28 (7): 1967–82. doi:10.1148/rg.287085067. PMID 19001652.
↑ Grus T, Lambert L, Grusová G, Banerjee R, Burgetová A (2017). “Budd-Chiari Syndrome”. Prague Med Rep. 118 (2–3): 69–80. doi:10.14712/23362936.2017.6. PMID 28922103.