Budd-Chiari Syndrome and hepatic regenerative nodules: Magnetic resonance findings with emphasis of hepatobiliary phase.

Budd-Chiari syndrome (BCS) is a disorder with numerous causes that is a result of hepatic outflow obstruction, in the absence of right heart failure or constrictive pericarditis. Acute Budd-Chiari syndrome is uncommon and clinically characterized by ascites, hepatomegaly, and hepatic insufficiency. In the majority of cases, patients present with chronic BCS, showing a dysmorphic liver disease with variable fibrosis deposition. In chronic Budd-Chiari syndrome, hepatocellular carcinoma (HCC) and benign regenerative nodules (called large regenerative nodules or FNH-like lesions) have been described in the literature. Very few studies have reported magnetic resonance imaging (MRI) findings about these nodules, using hepatobiliary contrast medium. The aim of our review is to describe the magnetic resonance imaging findings of hepatic regenerative nodules in BCS, with emphasis on the hepatobiliary phase, and to compare the imaging features of benign nodules with those of HCC.

Radiation Doses to Operators in Hepatobiliary Interventional Procedures.

PURPOSE: The primary aim of this study is to provide a summary of operators' radiation doses during hepatobiliary fluoroscopic guided procedures. In addition, patient dose in these procedures was also documented. MATERIALS AND METHODS: A total of 283 transarterial chemoembolisation (TACE) and 302 biliary procedures, including 52 percutaneous transhepatic cholangiogram (PTC), 36 bilioplasty and 214 biliary catheter changes (BCC) performed over 14 months, were included. Electronic personal dosimeters were used to measure operator radiation doses. Effective dose (E) was calculated using modified Niklason algorithm. Patient dose was measured as dose area product (DAP) and fluoroscopy time (FT). RESULTS: For TACE, E for radiologist ranged between 0 and 9.96 µSv, for radiographer 0-0.99 µSv and for nurse 0-4.65 µSv. The patient DAP and FT ranged between 1.5 and 421.9 Gy cm2 and 1.91-67.25 min. For PTC, E for the radiologist ranged between 0.33 and 55.89 µSv, for radiographer 0-38.61 µSv and for nurse 0-3.18 µSv. Patient DAP and FT ranged between 1.7 and 218.4 Gy cm2 and 2.07-71.53 min. For bilioplasty, E ranged between 0.09 and 9.24 µSv for radiologist, 0-0.84 µSv for radiographer and 0-1.38 µSv for nurse. The patients' DAP and FT ranged from 0.7 to 52.54 Gy cm2 and 1.13-24.47 min. For BCC, E ranged from 0 to 12.78 µSv for radiologist, 0-8.43 µSv for radiographer and 0-4.05 µSv for nurse. Patient DAP and FT ranged between 0.12 and 117.3 Gy cm2 and 0.57-15.83 min. CONCLUSIONS: This study shows that doses to all operators performing hepatobiliary interventional procedures can be very low.