title: Sonographic classification of draining pathways of obstructed hepatic veins in Budd-Chiari syndrome.
abstract: OBJECTIVE
  To describe and propose a sonographic classification of the blood-draining pathways of obstructed hepatic veins in Budd-Chiari syndrome.
  
  
  METHODS
  This retrospective study included 206 patients with hepatic vein obstructions who underwent sonographic examination. We evaluated the afflicted hepatic veins, as well as the course, orifice, blood flow direction of draining veins, and communicating branches. Results were classified and compared with digital subtraction angiography and computed tomography angiography.
  
  
  RESULTS
  Of 618 hepatic veins in 206 patients, 542 were obstructed. The blood-draining pathways were classified as hepatic vein-accessory hepatic vein (131/206), hepatic vein-hepatic vein/accessory hepatic+hepatic vein (49/206), and, less frequently, collateral pathways (26/206). Blood was drained from obstructed hepatic veins to the inferior vena cava, right atrium, para-umbilical veins, or hepatic subcapsular veins through communicating branches of various number and diameters. Doppler signals were obtained from the draining veins.
  
  
  CONCLUSIONS
  Sonography provides accurate information regarding the blood-draining pathways of obstructed hepatic veins in Budd-Chiari syndrome, which may be helpful for treatment and follow-up.
authors.affiliation: Department of Ultrasound, Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, 250021, China.
authors.forename: Yong-Hao
authors.initials: YH
authors.lastname: Gai
authors.forename: Shi-Feng
authors.initials: SF
authors.lastname: Cai
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Guo
authors.forename: Chun-Qing
authors.initials: CQ
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Liang
authors.forename: Tao
authors.initials: T
authors.lastname: Jia
authors.forename: Guo-Quan
authors.initials: GQ
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult
keywords: collateral pathways; duplex and color Doppler ultrasonography; hepatic vein thrombosis; ultrasonography