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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:373-379 • 0278-4297

Image Presentation

Sonography in Budd-Chiari Syndrome

Nitin Chaubal, MD, DMRD, Manjiri Dighe, MD, DMRE, Vijay Hanchate, MD, Hemangini Thakkar, MD, Hemant Deshmukh, MD and Krantikumar Rathod, MD

Thane Ultrasound Centre, Thane, India (N.C.); King Edward Hospital and Seth G. S. Medical College, Mumbai, India (N.C., V.H., H.T., H.D., K.R.); University of Washington Medical Center, Seattle, Washington USA (M.D.); and Jaslok Hospital and Research Center, Mumbai, India (N.C.).

Address correspondence to Nitin Chaubal, MD, DMRD, Thane Ultrasound Centre, Shanti Nivas, Dr Moose Road, Talaopali, Thane 400601, India. E-mail: chaubal{at}bom3.vsnl.net.in

Objective. The objective of this presentation is to provide an overview of sonographic manifestations of Budd-Chiari syndrome (BCS). Methods. Patients were scanned with ultrasound systems using mainly a 2- to 5-MHz curvilinear transducer and in some patients a 5- to 12-MHz linear transducer. The patients were asked to fast from the previous night or for at least 6 hours. Color and spectral Doppler sonography was performed in all patients. Results. Commonly seen findings in BCS include inferior vena cava (IVC) webs and thrombi, IVC narrowing, hepatic venous thrombosis, enlarged caudate lobes, ascites, intrahepatic or extrahepatic collaterals, monophasic to absent flow in the hepatic veins, and high flow velocities in areas of stenosis in the IVC or hepatic veins. Inferior vena cava stents used in the treatment of BCS could also be seen. Conclusions. Budd-Chiari syndrome is an uncommon disorder; outcome is poor in many cases; and the condition is often misdiagnosed or underdiagnosed. Sonography is a noninvasive and effective modality for diagnosis of BCS.

Key Words: Budd-Chiari syndrome • hepatic Doppler sonography • inferior vena cava abnormalities

Abbreviations: BCS, Budd-Chiari syndrome • IVC, inferior vena cava

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.