CTAP in budd-chiari syndrome: evaluation of intrahepatic portal flow.
BACKGROUND
To assess the intrahepatic portal flow in patients with Budd-Chiari syndrome (BCS) by computed tomography (CT) during arterial portography (CTAP).


METHODS
Five patients with BCS [with (n = 3) and without (n = 2) inferior vena cava (IVC) obstruction] underwent both CTAP and postcontrast CT following CTAP. CTAP and postcontrast CT after angioplasty were also performed in one patient. Findings on CTAP and postcontrast CT were analyzed retrospectively.


RESULTS
Patients with IVC obstruction and a patent large hepatic vein showed homogeneous hepatic enhancement on CTAP. Patients without IVC obstruction and with no patent large hepatic veins showed heterogeneous hepatic enhancement, which consisted of patchy enhancement and more definite enhancement in the central part of the liver. On postcontrast CT, the patchy enhancement was enlarged compared with that on CTAP in these patients. The heterogeneous hepatic enhancement became homogeneous in the patient who underwent angioplasty.


CONCLUSIONS
We suggest that the more marked the blood congestion, the more heterogeneous the hepatic enhancement becomes on CTAP. Heterogeneous hepatic enhancement on CTAP is seen in such cases without any patent hepatic veins.
Ueda
K
K
Department of Radiology, Kanazawa University School of Medicine, Kanazawa, Japan.
Matsui
O
O
Kadoya
M
M
Yoshikawa
J
J
Gabata
T
T
Kawamori
Y
Y
Takashima
T
T
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D001783:Blood Flow Velocity; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D003287:Contrast Media; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D007455:Iodine; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011172:Portography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000502:physiology
D003287:Contrast Media; D007455:Iodine