title: Budd-Chiari syndrome: a prospective analysis of hepatic vein obstruction on ultrasonography, multidetector-row computed tomography and MR imaging.
abstract: OBJECTIVE
  The goal of this study was to prospectively describe the imaging presentation of hepatic vein (HV) obstruction in patients with Budd-Chiari syndrome (BCS) on duplex and color Doppler ultrasonography (DCD-US), multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI).
  
  
  METHODS
  A total of 176 patients with primary BCS (mean age, 33 years; 101 women) were prospectively included. BCS diagnosis was made by direct visualization of HV and/or upper portion of the inferior vena cava (IVC) obstruction on DCD-US and/or MDCT and/or MRI. Location (right, middle, and left HV), type (thrombus, stenosis, or both), and age (recent vs. long-standing) of HV obstruction were described on each imaging examination.
  
  
  RESULTS
  HV obstruction was a constant (100%) finding and associated with IVC abnormalities in 51/176 (28.98%) patients. Obstruction of the three HVs was present in 158/176 (89.77%) patients. The prevalences of right, middle, and left HV thrombus were 151/169 (89.35%), 146/169 (86.39%), and 111/169 (65.68%), respectively. Long-standing HV thrombus was observed in more than 92% of patients on the three imaging methods. Agreement between DCD-US, MDCT, and MRI was perfect in the identification of long-standing HV thrombus (κ = 0.9); this agreement was slight to moderate in revealing the type of HV abnormality (i.e., fibrotic cord and non-visible HV).
  
  
  CONCLUSIONS
  Our results indicate that BCS is a chronic and insidious disease, more often discovered at an advanced stage. These results should warrant further evaluation of screening strategies in patients with risk factors for BCS to identify the disease at an early stage.
authors: Department of Radiology, Centre Pierre et Marie Curie, Place du 1er Mai, 16016, Alger, Algeria, faraounsid@yahoo.fr.
authors: Sid Ahmed
authors: SA
authors: Faraoun
authors: Mohamed El Amine
authors: Mel A
authors: Boudjella
authors: Nabil
authors: N
authors: Debzi
authors: Nawel
authors: N
authors: Afredj
authors: Youcef
authors: Y
authors: Guerrache
authors: Naima
authors: N
authors: Benidir
authors: Chafik
authors: C
authors: Bouzid
authors: Kamel
authors: K
authors: Bentabak
authors: Philippe
authors: P
authors: Soyer
authors: Salah Eddine
authors: SE
authors: Bendib
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography; D055815:Young Adult