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Liver CT Appearances



Budd-Chiari Syndrome CT Findings

  • Patchy enhancement especially in arterial phase with increased enhancement of central portion of the liver
  • Enlarged caudate lobe
  • Compressed IVC
  • Absence of hepatic veins
  • Ascites
  • Regenerating nodules
  • Acute phase
    • Early enhancement of caudate love and central portion of liver around IVC, with decreased enhancement of the rest of the liver
    • Delayed enhancement of peripheral portions of liver and central portion of low density (called “flip-flop appearance”)
    • Narrow hypodense hepatic vein and IVC with dense walls
  • Chronic
    • Failure to visualize IVC or hepatic veins
    • Intrahepatic collateral veins
    • Heterogenous liver enhancement
    • Large avidly enhancing regenerative nodules
    • Marked caudate hypertrophy with peripheral atrophy

Budd-Chiari Syndrome CT Findings

Related Pearls: Budd-Chiari

Related Lectures:
MDCT Evaluation of Parenchymal Liver Disease Part 2
Evaluation of the IVC: Spectrum of Disease - Part 2

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