The Contrast-enhanced CT Diagnostic Value on Hepatic Sinusoidal Obstruction Syndrome

Objective: To evaluate the diagnostic value of contrast-enhanced CT in hepatic sinusoidal obstruction syndrome (HSOS). Materials and Methods: Six patients (2 males and 4 females) diagnosed with HSOS by clinical and imaging in our hospital were included in this study. All patients underwent contrast-enhanced CT examination. Observed the changes of liver parenchyma, liver related blood vessels and other images within the scanning range in contrast-enhanced CT imaging. The results of hepatic vascular ultrasound, angiography or contrast-enhanced MR were also referred. The characteristics of contrast-enhanced CT in HSOS were analyzed and summarized. Results: All 6 cases showed liver swelling and uneven decrease of liver parenchyma density in non-enhanced CT image. After enhancement, 6 cases displayed "patchy" or "geographic pattern" enhancement. In 1 case, there was also characteristic "radial shape" high density centered on the second hilum along the around of three hepatic veins. The three hepatic veins in 5 cases were not shown. In the other 1 case, the left hepatic vein was not shown, the middle and right hepatic vein became thin like a line. The hepatic segment of inferior vena cava was severely narrowed in 3 cases and slightly compressed in 3 cases. However, hepatic vascular ultrasound, angiography or contrast-enhanced MR examination confirmed that the venous blood flow in the hepatic vein and the inferior vena cava was smooth. Conclusion: Liver swelling and uneven decrease of liver parenchyma density in non-enhanced CT image and "patchy" or "geographic pattern" enhancement or characteristic "radial shape" high density centered on the second hilum along the around of three hepatic veins in contrast-enhanced CT, which contributes to the diagnosis of HSOS. However, contrast-enhanced CT has some limitations in the diagnosis of hepatic vein or inferior vena cava hepatic segment stenosis or occlusion.