Hepatic veno-occlusive disease after taking Gynura Rhizome: The value of multidetector computed tomography in diagnosing the disease and evaluating the clinical therapeutic effect.

OBJECTIVE

We conducted this study to evaluate the role of multidetector computed tomography (MDCT) in diagnosing and differential diagnosis hepatic veno-occlusive disease (HVOD), and as well as assessing the clinical therapeutic effects.

METHODS

From 2007 to 2010, 10 inpatients with weight increasing, liver pains, ascites, jaundice and history of taking gynura rhizome before hospitalization were scanned with a 64-MDCT. The data were reconstructed every 0.625 mm and reviewed using multiplanar reconstruction (MPR) and liver CT angiography (CTA) on a GE AW4.2 workstation. Patients were re-scanned with MDCT after medication so that the clinical therapeutic effect could be evaluated before the patients discharging from hospital.

RESULTS

In 10 HVOD patients, the diagnoses of MDCT were coincident with clinical results. All patients had ascites and pleural fluid, hepatomegaly except the caudate lobe in MDCT. Failure to view hepatic veins in hepatic 3 phase scans, but portal veins and inferior vena cava were unobstructed. In portal-phase, hepatic enhancements were non-uniform. Three patients were incorrectly diagnosed before hospital admission. All patients improved significantly after hepato-protection and supporting therapy. No ascites, hydrothorax, hepatomegaly and obstruction of hepatic veins were observed by MDCT before patients were discharged from hospital.

CONCLUSIONS

Multidetector computed tomography combined with MPR and liver CTA images are helpful in the diagnosis and differential diagnosis of HVOD and in the evaluation of clinical therapeutic effects.