CTAP IN BUDD-CHIARI-SYNDROME - EVALUATION OF INTRAHEPATIC PORTAL FLOW

Background: To assess the intrahepatic portal flow in patients with Bu dd-Chiari syndrome (BCS) by computed tomography (CT) during arterial p ortography (CTAP). Methods. Five patients with BCS [with (n = 3) and w ithout (n = 2) inferior vena cava (IVC) obstruction] underwent both CT AP and postcontrast CT following CTAP. CTAP and postcontrast CT after angioplasty were also performed in one patient. Findings on CTAP and p ostcontrast CT were analyzed retrospectively. Results: Patients with N C obstruction and a patent large hepatic vein showed homogeneous hepat ic enhancement on CTAP. Patients without IVC obstruction and with no p atent large hepatic veins showed heterogeneous hepatic enhancement, wh ich consisted of patchy enhancement and more definite enhancement in t he central part of the liver. On postcontrast CT, the patchy enhanceme nt was enlarged compared with that on CTAP in these patients. The hete rogeneous hepatic enhancement became homogeneous in the patient who un derwent angioplasty. Conclusion: We suggest that the more marked the b lood congestion, the more heterogeneous the hepatic enhancement become s on CTAP. Heterogeneous hepatic enhancement on CTAP is seen in such c ases without any patent hepatic veins.