Hepatic veno‐occlusive disease after taking Gynura Rhizome: The value of multidetector computed tomography in diagnosing the disease and evaluating the clinical therapeutic effect

Wu, Xingwang; Wang, Wanqin; Liu, Bin; Xu, Jianming; Yu, Yongqiang; Zhang, Shuai; Shen, Yun

doi:10.1111/j.1872-034x.2011.00918.x

Cited by 22 publications

(14 citation statements)

References 19 publications

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“…The typical computed tomography (CT) findings include diffuse hepatomegaly, and plain scans reveal heterogeneous decreased density of the hepatic parenchyma. Enhancement is characterized by a map‐like or mottle‐like nonhomogeneous appearance in the venous phase and equilibrium phase and a low‐density area of edema, that is, a halo sign around the portal vein.…”

Section: Imaging Studiesmentioning

confidence: 99%

Expert consensus on the clinical management of pyrrolizidine alkaloid‐induced hepatic sinusoidal obstruction syndrome

Zhuge

Liu

Zou

et al. 2019

J of Gastro and Hepatol

138

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Hepatic sinusoidal obstruction syndrome (HSOS) is a hepatic vascular disease presenting with abdominal distension, pain in the hepatic region, ascites, jaundice, and hepatomegaly. In China, this disease is often associated with the oral intake of plants that contain pyrrolidine alkaloids. The existing guidelines are limited to HSOS associated with hematopoietic stem cell transplantation in Western countries. The Hepatobiliary Diseases Committee of the Chinese Society of Gastroenterology convened an expert consensus conference on the diagnosis and treatment of PA–HSOS to evaluate current research in China and abroad. The “Nanjing criteria” developed by the committee to diagnose PA–HSOS include a confirmed history of PA‐containing plant use and (i) abdominal distention and/or pain in the hepatic region, hepatomegaly, and ascites; (ii) elevation of serum total bilirubin or abnormal laboratory liver tests; (iii) evidence on enhanced computed tomography or magnetic resonance imaging; or (iv) pathological evidence that rules out other known causes of liver injury. Supportive symptomatic treatment, anticoagulant therapy, and placement of a transjugular intrahepatic portosystemic shunt for patients who do not respond to medical treatment are effective for the treatment of PA–HSOS. The benefits of glucocorticoids and prostaglandin E1 in PA–HSOS are not clear.

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Section: Imaging Studiesmentioning

confidence: 99%

Expert consensus on the clinical management of pyrrolizidine alkaloid‐induced hepatic sinusoidal obstruction syndrome

Zhuge

Liu

Zou

et al. 2019

J of Gastro and Hepatol

138

View full text Add to dashboard Cite

show abstract

“…No high‐quality prospective studies on PA‐HVOD have been published to date. Although some authors studied the imaging findings of PA‐HVOD, there are no systematic studies of the clinical features and treatment of this disease. In patients with HSCT‐HVOD, defibrase is the only effective therapeutic agent .…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and treatment of pyrrolizidine alkaloid‐related hepatic vein occlusive disease

Zhuge

Wang

Zhang

et al. 2018

Liver International

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“…For these cases, a detailed history as well as radiologic evaluation can play important roles in diagnosing this disease. To dates, the reports of radiologic features of HSOS, both related and unrelated to herbal medicines, have been limited (14-17). The aim of this paper is to describe the CT and MRI features of 16 cases of HSOS caused by herbal medicine Gynura segetum .…”

Section: Introductionmentioning

confidence: 99%

Hepatic Sinusoidal Obstruction Syndrome Caused by Herbal Medicine: CT and MRI Features

et al. 2014

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ObjectiveTo describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum.Materials and MethodsThe CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images.ResultsAscites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565).ConclusionAscites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.

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Hepatic veno‐occlusive disease after taking Gynura Rhizome: The value of multidetector computed tomography in diagnosing the disease and evaluating the clinical therapeutic effect

Abstract: Multidetector computed tomography combined with MPR and liver CTA images are helpful in the diagnosis and differential diagnosis of HVOD and in the evaluation of clinical therapeutic effects.

Cited by 22 publications

References 19 publications

Expert consensus on the clinical management of pyrrolizidine alkaloid‐induced hepatic sinusoidal obstruction syndrome

Expert consensus on the clinical management of pyrrolizidine alkaloid‐induced hepatic sinusoidal obstruction syndrome

Clinical characteristics and treatment of pyrrolizidine alkaloid‐related hepatic vein occlusive disease

Hepatic Sinusoidal Obstruction Syndrome Caused by Herbal Medicine: CT and MRI Features

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