BMC Gastroenterol. 2013 Jun 24;13:105. doi: 10.1186/1471-230X-13-105.
Hepatocellular carcinoma associated with Budd-Chiari syndrome: imaging features
and transcatheter arterial chemoembolization.
Liu FY, Wang MQ, Duan F, Fan QS, Song P, Wang Y.
Department of Interventional Radiology, Chinese People's Liberation Army General
Hospital, 28 Fuxing Road, Beijing 100853, China.
BACKGROUND: Budd-Chiari syndrome (BCS) often leads to hepatocellular carcinoma
(HCC). Transcatheter arterial chemoembolization (TACE) has been increasingly used
to treat BCS patients with HCC. The purposes of this study were to illustrate
imaging features in BCS patients with HCC, and to analyze the effects of TACE on
BCS patients with HCC.
METHODS: 246 consecutive patients with primary BCS were retrospectively studied.
14 BCS patients with HCC were included in this study. BCS were treated with
angioplasty and/or stenting, and HCC were managed with TACE. Imaging features on
ultrasonography, CT, MRI, and angiography and the serum AFP level were analyzed.
RESULTS: Inferior vena cava block and stricture of hepatic venous outflow tract
more frequently occurred. Portal vein invasion was found in only 2 patients
(14.2%). Imaging studies showed that most nodules of HCC were near the edge of
liver, irregular, more than 3 cm in diameter, heterogeneous mass and solitary (≤3
nodules). HCC in patients associated with BCS was isointense or hypointense in
nonenhanced CT images, and exhibited heterogeneous enhancement during the
arterial phase and washout during the portal venous phase on enhanced CT and MRI.
The serum AFP level significantly declined after TACE treatment.
CONCLUSIONS: BCS patients with inferior vena cava block and stricture of hepatic
venous outflow tract seems to be associated with HCC. A single, large, irregular
nodule with a peripheral location appears to be HCC. TACE can effectively treat
HCC in BCS patients.