Ilustrate the Doppler findings in:
- acute Budd-Chiari for diagnostic purpose;
- chronic and non-treated Budd-Chiari,
- treated Budd-Chiari and how to evaluate it's success.
Budd–Chiari is a condition caused by outflow obstruction of the hepatic veins related to hyper coagulablestates,
including: myeloproliferative syndromes,
paroxysma nocturnal hemoglobinuria,
factor V mutation,
protein C and S deficiencies; some abdominal cancers anduse of hormonal contraceptives (associated with any of the above factors).
The blockage causescongestion of the synusoids leading to an increase of liver's size.
The reduced blood flow generatesatrophy and necrosis of centrilobular hepatocytes,
followed by fibrosis.
In the acute phase abdominal pain/disconfort and...
Findings and procedure details
The sonographic evaluation of the liver starts with the analysis on B-mode of it's margins,
echotexture and the study of the hepatic veins and retro-hepatic inferior vena cava (IVC).
In the acute form of Budd-Chiari ultrasound shows hepatomegaly and ascites.
If non diagnosed and succesfully treated,
with time the liver developssigns of chronic hepatopaty such as blunt edges,
jagged outline and heterogeneous echotexture (fig.1) with signs of portal hypertension (increased diameter of portal,
splenic and superior mesenteric veins,
ascites and splenomegaly).
As the segment...
Budd–Chiari has a deadly potential but can be reversible if diagnosed on time.
B modeand Doppler ultrasound play an important role in diagnosis and follow up after intervention.It demonstrates not only the late morphological changes in the liver but also allows to observe thrombus and absense of flow within the hepatic veins.
in a more late phase,
venous collaterals develops and shunts with the portal and systemic veins are formed the typical "comma" shape must be recognised.
The knowledge of the pattern of the...
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Classification of hepatic venous outflow obstruction: ambiguous terminology of the Budd-Chiari...