Vascular Radiology in the Budd-Chiari Syndrome

In six cases of Budd-Chiari syndrome, wedged hepatic venography and inferior vena cavography were performed, and hepatic arteriography was carried out in two of these cases. Specific patterns on the wedged hepatic venogram seen only in this condition are described. Narrowing of the upper end of the inferior vena cava is demonstrated radiographically in this condition. This may be associated with intrinsic filling defects thought to be due to thrombus formation in the upper end of the inferior vena cava. On hepatic arteriography there is marked narrowing of the vessels and these appear bowed. The spider's-web network pattern as well as actual occlusion of a hepatic vein, is considered to be pathognomic of the Budd-Chiari syndrome.