title: Diagnostic performance of Contrast-enhanced CT in Pyrrolizidine Alkaloids-induced Hepatic Sinusoidal Obstructive Syndrome.
abstract: Hepatic sinusoidal obstruction syndrome (HSOS) can be caused by pyrrolizidine alkaloids(PAs)-containing herbals. Since PAs exposure is obscure and clinical presentation of HSOS is unspecific, it is challenge to establish the diagnosis of PAs-induced HSOS. Gynura segetum is one of the most wide-use herbals containing PAs. The aim of our study is to describe the features of contrast-enhanced computed tomography (CT) in gynura segetum-induced HSOS, and then determine diagnostic performance of radiological signs. We retrospectively analyzed medical records and CT images of HSOS patients (71 cases) and the controls (222 cases) enrolled from January 1, 2008, to Oct 31, 2015. The common findings of contrast CT in PAs-induced HSOS included: ascites (100%), hepatomegaly (78.87%), gallbladder wall thickening (86.96%), pleural effusion (70.42%), hepatic vein narrowing (87.32%), patchy liver enhancement (92.96%), and heterogeneous hypoattenuation (100%); of these signs, patchy enhancement and heterogeneous hypoattenuation were valuable features. Then, the result of diagnostic performance demonstrated that contrast CT possessed better performance in diagnosing PAs-induced HSOS compared with various parameters of Seattle criteria. In conclusion, the patients with PAs-induced HSOS display distinct radiologic features at CT-scan, which reveals that contrast-enhanced CT provides an effective noninvasive method for diagnosing PAs-induced HSOS.
authors.affiliation: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Kan
authors.affiliation: Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Jin
authors.initials: J
authors.lastname: Ye
authors.affiliation: Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Rong
authors.affiliation: Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Zhiwen
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Ling
authors.initials: L
authors.lastname: Yang
authors.affiliation: Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Keshu
authors.initials: K
authors.lastname: Xu
authors.affiliation: Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Yuhu
authors.initials: Y
authors.lastname: Song
authors.affiliation: Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Hou
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003287:Contrast Media; D004365:Drugs, Chinese Herbal / Q000737:chemistry*; D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006529:Hepatomegaly / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011763:Pyrrolizidine Alkaloids / Q000009:adverse effects*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D004365:Drugs, Chinese Herbal; D011763:Pyrrolizidine Alkaloids; C000600512:tusanqi