Sonography of the Caudate vein:: Value in diagnosing Budd-Chiari syndrome

OBJECTIVE. The aim of this study was to evaluate the usefulness of sonography in measuring the caudate vein and lobe when diagnosing Budd-Chiari syndrome. MATERIALS AND METHODS. Our study included a group of 16 patients with Budd-Chiari syndrome. We compared this patient group with a control group of 40 patients with cirrhosis and 66 healthy subjects without liver disease. On sonography, we measured the diameter of the caudate lobe and the presence and diameter of the caudate vein. These measurements were then compared for both groups. RESULTS. In half of the patients with Budd-Chiari syndrome, sonography showed a visible caudate vein (3-21 mm; mean, 7.3 mm; median, 4.6 mm). However, in the control group, spontaneous visualization was seen in only eight (7.5%) of 106 subjects, none of whom had cirrhosis. The caudate lobe was larger in patients with cirrhosis than in healthy subjects. Likewise, in patients with Budd-Chiari syndrome, the caudate lobe was larger than that in patients with cirrhosis. CONCLUSION. When sonography reveals a caudate vein equal to or larger than 3 mm in diameter in the appropriate clinical setting, one should strongly suspect Budd-Chiari syndrome.