Changes in Liver Congestion in Patients with Budd-Chiari Syndrome following Endovascular Interventions: Assessment with Transient Elastography.
OBJECTIVE
Transient elastography (TE) is routinely used for noninvasive staging of hepatic fibrosis. The objective of the present study was to investigate the role of TE (FibroScan) in determining changes in liver congestion in patients with Budd-Chiari syndrome (BCS) treated by endovascular interventions and determine the effects of pretreatment Meta-analysis of Histological Data in Viral Hepatitis (METAVIR) fibrosis score on posttreatment liver stiffness (LS).


METHODS
Twenty-five patients undergoing endovascular procedures for treatment of BCS underwent TE immediately before and within 24 hours after the procedure. Fifteen patients available for 3-month follow-up were again subjected to TE. Mean LS values before and after intervention were compared in 12 of these patients for whom METAVIR scores were available. Pressure gradient changes across the stenosed hepatic veins/inferior vena cava were measured during the procedure. Statistical analysis of these data was performed by Wilcoxon signed-rank test, Mann-Whitney U test, and Pearson product-moment correlation coefficient.


RESULTS
Significant differences were found between mean LS measurements before and within 24 hours after intervention (Z-score = 4.372) and between the mean values obtained before and 3 months after treatment (Z-score = 3.408). Mean changes in LS values after intervention in patients with METAVIR fibrosis scores ≤ 2 and > 2 were not significant. There was no correlation between changes in pressure gradients and the degree of LS.


CONCLUSIONS
TE is a useful tool to assess the reduction in hepatic congestion in patients with BCS undergoing endovascular interventions.
Departments of Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi110070, India. Electronic address: dramarmukund@gmail.com.
Amar
A
Mukund
Departments of Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi110070, India.
Sudheer S
SS
Pargewar
Departments of Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi110070, India.
Saloni N
SN
Desai
Departments of Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi110070, India.
S
S
Rajesh
Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi110070, India.
Shiv K
SK
Sarin
D000293:Adolescent; D000328:Adult; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy*; D002648:Child; D054459:Elasticity Imaging Techniques; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome