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Budd-Chiari Syndrome
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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16
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5

KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Budd-Chiari syndrome (BCS)
          • Synonyms

            • Hepatic venous outflow obstruction
          • Definitions

            • Global or segmental hepatic venous outflow obstruction
              • At level of large hepatic veins or suprahepatic segment of inferior vena cava (IVC) to right atrium

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Vernuccio F et al: Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting. Insights Imaging. 12(1):8, 2021
                                            2. Olson MC et al: Venous thrombosis and hypercoagulability in the abdomen and pelvis: causes and imaging findings. Radiographics. 40(3):875-94, 2020
                                            3. Mamone G et al: Budd-Chiari syndrome and hepatic regenerative nodules: magnetic resonance findings with emphasis of hepatobiliary phase. Eur J Radiol. 117:15-25, 2019
                                            4. Yoneda N et al: Benign hepatocellular nodules: hepatobiliary phase of gadoxetic acid-enhanced MR imaging based on molecular background. Radiographics. 36(7):2010-27, 2016
                                            5. Søreide K: Acute Budd-Chiari syndrome associated with non-viral cryptogenic hepatocellular carcinoma: revisiting the 'chicken or the egg' theory. Hepatogastroenterology. 61(130):388-90, 2014
                                            6. Akyüz F et al: Anticoagulant therapy and Budd-Chiari syndrome: is it successful? Hepatogastroenterology. 58(107-108):900-3, 2011
                                            7. Chen H et al: Budd--Chiari syndrome caused by multiple membranous obstruction of the inferior vena cava in a young man. Ann Vasc Surg. 25(8):1139, 2011
                                            8. Dang XW et al: Surgical treatment of Budd-Chiari syndrome: analysis of 221 cases. Hepatobiliary Pancreat Dis Int. 10(4):435-8, 2011
                                            9. Loomes DE et al: Acute Budd-Chiari syndrome. Can J Gastroenterol. 25(6):302-3, 2011
                                            10. Mukund A et al: Radiological interventions in HVOTO--practical tips. Trop Gastroenterol. 32(1):4-14, 2011
                                            11. Renzulli M et al: Large regenerative nodules in a patient with Budd-Chiari syndrome after TIPS positioning while on the liver transplantation list diagnosed by Gd-EOB-DTPA MRI. Hepatobiliary Pancreat Dis Int. 10(4):439-42, 2011
                                            12. Roullet S et al: Thrombocytopenia and acute Budd-Chiari syndrome after liver transplantation: heparin-induced thrombocytopenia. Br J Anaesth. 107(3):475-7, 2011
                                            13. Valla DC: Primary Budd-Chiari syndrome. J Hepatol. 50(1):195-203, 2009
                                            14. Karaosmanoglu D et al: CT, MRI, and US findings of incidental segmental distal hepatic vein occlusion: a new form of Budd-Chiari syndrome?. J Comput Assist Tomogr. 32(4):518-22, 2008
                                            15. Lupescu IG et al: Spiral computed tomography and magnetic resonance angiography evaluation in Budd-Chiari syndrome. J Gastrointestin Liver Dis. 17(2):223-6, 2008
                                            16. Chaubal N et al: Sonography in Budd-Chiari syndrome. J Ultrasound Med. 25(3):373-9, 2006
                                            17. Lee BB et al: Primary Budd-Chiari syndrome: outcome of endovascular management for suprahepatic venous obstruction. J Vasc Surg. 43(1):101-8, 2006
                                            18. Brancatelli G et al: Benign regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: radiologic-pathologic and clinical correlation. Radiographics. 22(4):847-62, 2002
                                            19. Brancatelli G et al: Large regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinicopathologic correlation. AJR Am J Roentgenol. 178(4):877-83, 2002
                                            20. Vilgrain V et al: Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology. 210(2):443-50, 1999
                                            21. Kane R et al: Diagnosis of Budd-Chiari syndrome: comparison between sonography and MR angiography. Radiology. 195(1):117-21, 1995
                                            22. Millener P et al: Color Doppler imaging findings in patients with Budd-Chiari syndrome: correlation with venographic findings. AJR Am J Roentgenol. 161(2):307-12, 1993
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Pathology

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Budd-Chiari syndrome (BCS)
                                                    • Synonyms

                                                      • Hepatic venous outflow obstruction
                                                    • Definitions

                                                      • Global or segmental hepatic venous outflow obstruction
                                                        • At level of large hepatic veins or suprahepatic segment of inferior vena cava (IVC) to right atrium

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Angiographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Vernuccio F et al: Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting. Insights Imaging. 12(1):8, 2021
                                                                                      2. Olson MC et al: Venous thrombosis and hypercoagulability in the abdomen and pelvis: causes and imaging findings. Radiographics. 40(3):875-94, 2020
                                                                                      3. Mamone G et al: Budd-Chiari syndrome and hepatic regenerative nodules: magnetic resonance findings with emphasis of hepatobiliary phase. Eur J Radiol. 117:15-25, 2019
                                                                                      4. Yoneda N et al: Benign hepatocellular nodules: hepatobiliary phase of gadoxetic acid-enhanced MR imaging based on molecular background. Radiographics. 36(7):2010-27, 2016
                                                                                      5. Søreide K: Acute Budd-Chiari syndrome associated with non-viral cryptogenic hepatocellular carcinoma: revisiting the 'chicken or the egg' theory. Hepatogastroenterology. 61(130):388-90, 2014
                                                                                      6. Akyüz F et al: Anticoagulant therapy and Budd-Chiari syndrome: is it successful? Hepatogastroenterology. 58(107-108):900-3, 2011
                                                                                      7. Chen H et al: Budd--Chiari syndrome caused by multiple membranous obstruction of the inferior vena cava in a young man. Ann Vasc Surg. 25(8):1139, 2011
                                                                                      8. Dang XW et al: Surgical treatment of Budd-Chiari syndrome: analysis of 221 cases. Hepatobiliary Pancreat Dis Int. 10(4):435-8, 2011
                                                                                      9. Loomes DE et al: Acute Budd-Chiari syndrome. Can J Gastroenterol. 25(6):302-3, 2011
                                                                                      10. Mukund A et al: Radiological interventions in HVOTO--practical tips. Trop Gastroenterol. 32(1):4-14, 2011
                                                                                      11. Renzulli M et al: Large regenerative nodules in a patient with Budd-Chiari syndrome after TIPS positioning while on the liver transplantation list diagnosed by Gd-EOB-DTPA MRI. Hepatobiliary Pancreat Dis Int. 10(4):439-42, 2011
                                                                                      12. Roullet S et al: Thrombocytopenia and acute Budd-Chiari syndrome after liver transplantation: heparin-induced thrombocytopenia. Br J Anaesth. 107(3):475-7, 2011
                                                                                      13. Valla DC: Primary Budd-Chiari syndrome. J Hepatol. 50(1):195-203, 2009
                                                                                      14. Karaosmanoglu D et al: CT, MRI, and US findings of incidental segmental distal hepatic vein occlusion: a new form of Budd-Chiari syndrome?. J Comput Assist Tomogr. 32(4):518-22, 2008
                                                                                      15. Lupescu IG et al: Spiral computed tomography and magnetic resonance angiography evaluation in Budd-Chiari syndrome. J Gastrointestin Liver Dis. 17(2):223-6, 2008
                                                                                      16. Chaubal N et al: Sonography in Budd-Chiari syndrome. J Ultrasound Med. 25(3):373-9, 2006
                                                                                      17. Lee BB et al: Primary Budd-Chiari syndrome: outcome of endovascular management for suprahepatic venous obstruction. J Vasc Surg. 43(1):101-8, 2006
                                                                                      18. Brancatelli G et al: Benign regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: radiologic-pathologic and clinical correlation. Radiographics. 22(4):847-62, 2002
                                                                                      19. Brancatelli G et al: Large regenerative nodules in Budd-Chiari syndrome and other vascular disorders of the liver: CT and MR imaging findings with clinicopathologic correlation. AJR Am J Roentgenol. 178(4):877-83, 2002
                                                                                      20. Vilgrain V et al: Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology. 210(2):443-50, 1999
                                                                                      21. Kane R et al: Diagnosis of Budd-Chiari syndrome: comparison between sonography and MR angiography. Radiology. 195(1):117-21, 1995
                                                                                      22. Millener P et al: Color Doppler imaging findings in patients with Budd-Chiari syndrome: correlation with venographic findings. AJR Am J Roentgenol. 161(2):307-12, 1993