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World J Hepatol. Apr 27, 2014; 6(4): 251-262
Published online Apr 27, 2014. doi: 10.4254/wjh.v6.i4.251
Published online Apr 27, 2014. doi: 10.4254/wjh.v6.i4.251
Nuclear medicine dynamic investigations in the diagnosis of Budd-Chiari syndrome
Mircea Dragoteanu, Ioan-Adrian Balea, Cecilia-Diana Piglesan, Department of Nuclear Medicine, Regional Institute for Gastroenterology and Hepatology, Prof. Dr. Octavian Fodor, 400162 Cluj-Napoca, Romania
Author contributions: Dragoteanu M was the leader of the research team, coordinated the practical procedures, developed the method of using per-rectal portal scintigraphy and liver angioscintigraphy to investigate the liver hemodynamics, conducted the analysis of data and wrote the paper; Balea IA contributed to the data analysis and writing of the paper; Piglesan CD performed the practical procedures of the patients and acquisition of data.
Correspondence to: Dr. Mircea Dragoteanu, MD, PhD, Head of Nuclear Medicine Department, Institute for Gastroenterology and Hepatology, Prof. Dr. Octavian Fodor, Croitorilor Str. 19-21, 400162 Cluj-Napoca, Romania. dragoteanu@yahoo.co.uk
Telephone: +40-722-381851 Fax: +40-722-381851
Received: October 28, 2013
Revised: January 10, 2014
Accepted: February 20, 2014
Published online: April 27, 2014
Revised: January 10, 2014
Accepted: February 20, 2014
Published online: April 27, 2014
Core Tip
Core tip: Per-rectal portal scintigraphy (PRPS) and liver angioscintigraphy (LAS) are reliable investigations of the liver hemodynamics in the Budd-Chiari syndrome (BCS). Diagnosis of the number, length and succession in time of hepatic vein obstructions allows identification of hemodynamic varieties and stages of the BCS. Our new PRPS parameters, liver transit time and right heart to liver time, are used to diagnose obstructed hepatic veins, areas missing venous outflow or portal inflow, open collaterals, reverse splenic vein flow and hemodynamic role of the caudate lobe. LAS is useful in the differential diagnosis with portal occlusions, highlighting arterial-venous shunts and reverse portal flow.