Sonography and color Doppler imaging of Budd-Chiari syndrome of membranous obstruction of the inferior vena cava.

We examined 18 patients with Budd-Chiari syndrome (membranous obstruction of the hepatic IVC). IVC obstruction was detected by sonography in 17 cases (94%). The causes were a web in 10 cases and a fibrous cord in four cases. In three cases, the cause was unspecified. Obliteration of the hepatic veins or intrahepatic collateral vessels or both was delineated in 16 cases (89%). With seven cases of color Doppler imaging, there was no detectable color or Doppler signal within the IVC, and the direction of hepatic venous blood flow through intravenous communications was fairly well demonstrated in all cases. In four cases of follow-up color Doppler imaging, the patency of the IVC was well demonstrated. Sonography is useful in detecting obstruction of the hepatic IVC and in demonstrating the hepatic venous obstruction and intrahepatic collateral vessels. Color Doppler sonography is useful in demonstrating the direction of blood flow through interconnecting vessels and in evaluating the patency of the IVC after treatment.