BUDD-CHIARI SYNDROME - VALUE OF DUPLEX SONOGRAPHY AND COLOR DOPPLER IMAGING FOR DIAGNOSIS AND FOLLOW-UP

This retrospective study was designed to evaluate duplex sonography in the diagnosis and follow-up of patients with Budd-Chiari syndrome. Th irteen patients with clotting disease and histologically proven Budd-C hiari syndrome (3 acute and 10 chronic cases) were examined, using con ventional duplex sonography (n = 5) or colour-coded duplex sonography (n = 8). Results were compared with CT in 6 cases, MRI in 11, coeliac and mesenteric angiography in 5, and hepatic wedge venography and cavo graphy in 6. Of 39 hepatic veins examined, 33 had an abnormal appearan ce on ultrasound studies: endo-luminal thrombus stenosis, dilatation, thick wall echoes. Doppler findings included total obstruction of 8 he patic veins, reversed flow in 22 hepatic veins and intrahepatic collat erals with continuous non-phasic flow in all cases. Duplex sonography showed portal thrombosis (n = 1), evidence of portal hypertension (n = 8) and inferior vena cava thrombosis (n = 2). Nine patients were trea ted surgically. Patency of portocaval shunts was correctly assessed wi th colour-coded duplex sonography in 8 of 9 patients. We believe that colour Doppler imaging is the procedure of choice for initial diagnosi s of Budd-Chiari syndrome.