Hepatic Nodules in Budd-Chiari Syndrome: Imaging Features

Vilgrain, Valérie; Lewin, M.; Vons, C.; Denys, Alban; Valla, Dominique; Fléjou, Jean‐François; Belghiti, Jacques; Menu, Y.

doi:10.1148/radiology.210.2.r99fe13443

Cited by 179 publications

(116 citation statements)

References 18 publications

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“…In agreement with previous studies that have analyzed FNHlesions in patients with other vascular diseases, such as BuddChiari syndrome or congenital portosystemic shunt [9][10][11][12][13][14], we found that two imaging findings are the most common and distinctive features of FNH-like lesions. First, all lesions demonstrated intense and homogeneous contrast enhance- Corresponding gadolinium-enhanced, fat-suppressed T1-weighted 3D GRE images (212 ms/4 ms; 80°) show lesion's intense and homogeneous hyperintensity during the hepatic arterial dominant phase (c), which gradually fades to near isointensity compared with the background liver during the interstitial phase (d).…”

Section: Discussionsupporting

confidence: 92%

“…Although rare, CTPV can profoundly alter liver morphology and vascular haemodynamics, mimicking other hepatic disorders (most notably cirrhosis) [2][3][4][5][6]. In addition, recent anecdotal observations suggest that CTPV might foster the growth of hypervascular liver nodules with histological features and pathogenesis similar to that of focal nodular hyperplasialike (FNH-like) lesions found in other vascular disorders of the liver (e.g., Budd-Chiari syndrome, hereditary hemorrhagic telangectasia, congenital portosystemic shunt, and congenital hepatic fibrosis [7][8][9][10][11][12][13][14]). These lesions represent a benign hyperplasia of the hepatic parenchyma in response to increased arterial perfusion in areas with reduced or absent portal blood flow.…”

Section: Introductionmentioning

confidence: 99%

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Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history

et al. 2011

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history

et al. 2011

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“…Review of literature showed that benign nodules in Budd Chiari syndrome can show increased T2 signal intensity. 24 Central area altered signal intensity which is hypointense on T1 weighted images and hyperintense on T2 weighted images is noted in many nodules in this patient which corresponds with central scarring. In a study by Maetani et al of 15 lesions larger than 1 cm in diameter, a central scar was found in six nodules.…”

Section: Lesion Characterizationmentioning

confidence: 61%

Evaluation of focal liver lesions by magnetic resonance imaging and correlation with pathology

Rao¹,

Rao

2016

Int J Res Med Sci

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INTRODUCTIONLiver lesions are one of the most commonly encountered lesions. Annually thousands of patients undergo imaging for the work up of suspected or known liver masses.The main goals of imaging are to assess the number, size, location of the lesions relative to the vessels and nature of the lesions. The exact prevalence of benign liver masses is unknown but some studies suggest that they may be found in more than 20% of the general population. Recent studies suggest that small (<15 mm) lesions that are detected on CT are benign in more than 80% of the patients who have known malignancy.2 With the application of MDCT and thin collimation, it is likely that more liver lesions will be detected that will need additional imaging for characterization, most likely with MR imaging. ABSTRACT Background:The goals of imaging in focal liver lesions is to assess the number, size, location and characterize the lesions as benign / malignant with newer imaging modalities and confirmation of pathology by Fine needle aspiration cytology or by biopsy. This is essential for treatment planning and prognosis. Methods: A total of 42 patients detected to have focal lesions in liver on ultra-sonogram were characterized on MRI on the basis of morphology, signal characteristics, enhancement patterns. Extra hepatic spread is suggested by capsular breach, peritoneal metastases and lymph node enlargement. Tissue diagnosis was obtained by fine needle aspiration cytology/ Tru cut biopsy/ surgery. Hemangiomas and simple cysts were followed up for an average period of 7.5 months by imaging without biopsy. Results: Out of 42 patients, 28 were males (68%) and 14 were females (32%). The age range was 20 to 70 years with a mean age of 51 years for malignant lesions. The right lobe of liver was involved in 26 (62%), left lobe in 7 (17%) and both lobes in 9(21%) cases. There were 24 benign and 18 malignant lesions. The mean ADC value was 2.092 X 10 -3 sec/ mm 2 and 1.241 X 10 -3 sec/ mm 2 for benign and malignant lesions respectively. The difference in mean ADC values in both the groups was significant (p<0.0001). Conclusions: MRI was able to predict diagnosis in 38 of the 42 lesions (90%) which were proved on pathology or by follow up imaging. MRI could not provide specific diagnosis in two early abscess, one each of multifocal hepatocellular carcinoma and regenerative nodules. Thus MR imaging is a powerful tool for the evaluation of focal liver lesions.

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“…3D CE MRA found 2 patients with primary BCS developed HCC during a long-term follow-up period. The development of HCC in patients with chronic BCS has been reported in the literature [29] . According to that report, many factors, such as chronic viral infection or cirrhosis might play a role in the development of this malignancy.…”

Section: Discussionmentioning

confidence: 98%

Budd-Chiari syndrome: Diagnosis with three-dimensional contrast-enhanced magnetic resonance angiography

Lin

Chen²,

Zhou³

et al. 2003

WJG

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AIM:To evaluate the role of three-dimensional contrastenhanced magnetic resonance angiography (3D CE MRA) in the diagnosis of Budd-Chiari syndrome (BCS). METHODS:Twenty-three patients with BCS underwent 3D CE MRA examination, in which 13 cases were secondary to either hepatocellular carcinoma (11 cases), right adrenal carcinoma (1 case) or thrombophlebitis (1 case) and 10 suffered from primary BCS. The patency of the inferior vena cava (IVC), hepatic and portal veins as well as the presence of intra-and extrahepatic collaterals, liver parenchymal abnormalities and porto-systemic varices were evaluated. Inferior vena cavography was performed in 10 cases. The diagnosis of IVC obstruction by 3D CE MRA was compared with that demonstrated by inferior vena cavography.

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Hepatic Nodules in Budd-Chiari Syndrome: Imaging Features

Abstract: In patients with chronic Budd-Chiari syndrome, multiple (> 10) small (< 4-cm) lesions are suggestive of benignity.

Cited by 179 publications

References 18 publications

Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history

Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history

Evaluation of focal liver lesions by magnetic resonance imaging and correlation with pathology

Budd-Chiari syndrome: Diagnosis with three-dimensional contrast-enhanced magnetic resonance angiography

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