Budd-Chiari syndrome is a rare condition caused by hepatic venous outflow obstruction. Although liver bipsy and venography have been considered to be conclusive in the diagnosis of Budd-Chiari syndrome, those procedures involve a great deal of disecomfort and risk for the patient. As the recently developed Doppler ultrasonography is able to define the direction of blood flow and measure the blood flow velocity and volume in the portal vein, inferior vena cava(IVC) and hepatic vein, it can be used in the diagnosis of Budd-Chiari syndrome.
We analyzed Doppler ultrasonographic findings in two patients with membraneous obstruction of the IVC, suspected from Doppler ultrasonographic findings and confirmed by venocavography. Doppler ultrasonography demoonstrated reversed laminar flow on inspiration and no significant flow on expiration in the dilated IVC proximal to the stenosis and turbulent flow in the proximal portion of the stenosis.
After balloon dilatation, the flow was changed and directed normally. These findings correlated very well with venocavographic findings.
Our results suggest that Doppler ultrasonography is a simple, non-invasive and effective method for the initial evaluation of patients suspected of having obstruction of the IVC and the evaluation of therapeutic effect.