Case study: ypical imaging signs of hepatic sinusoidal obstruction syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Ziyuan , ZHAO Youjin , CHEN Weixia ,  LU Chunyan

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LU Chunyan, Email: luchunyan@wchscu.cn

Keywords：

hepatic sinusoidal obstruction syndrome; Budd-Chiari syndrome; imaging feature; diagnosis; differential diagnosis

DOI：

10.7507/1007-9424.202309095

Video：

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Abstract Full text Figures/Tables Video References Cited by

Hepatic sinusoidal obstruction syndrome (HSOS) can be easily missed or misdiagnosed as Budd-Chiari syndrome in clinical practice. The authors displayed the imaging pictures of 1 patient with HSOS and made a brief description of typical imaging features, underlying pathophysiological mechanisms, and differential diagnoses of HSOS, with the hope of improving the understanding of HSOS and reducing the rates of leak diagnosis or misdiagnosis.

1.	Mavrikou I, Chatzidimitriou D, Skoura L, et al. Molecular advances in sinusoidal obstruction syndrome/veno-occlusive disease. Int J Mol Sci, 2023, 24(6): 5620. doi: 10.3390/ijms24065620. doi: 10.3390/ijms24065620.
2.	Xu XT, Wang BH, Wang Q, et al. Idiopathic hypereosinophilic syndrome with hepatic sinusoidal obstruction syndrome: A case report and literature review. World J Gastrointest Surg, 2023, 15(7): 1532-1541.
3.	Tan Y, Zheng S. Clinicopathological characteristics and diagnosis of hepatic sinusoidal obstruction syndrome caused by Tusanqi - Case report and literature review. Open Med (Wars), 2023, 18(1): 20230737. doi: 10.1515/med-2023-0737.
4.	Lu F, Jia S, Lu H, et al. Primary Budd-Chiari syndrome versus sinusoidal obstruction syndrome: a review. Curr Med Res Opin, 2024, 40(2): 303-313.
5.	Kriege O, Kreft A, Hauptrock B, et al. Diagnosis of sinusoidal obstruction syndrome: can biopsy be the key? Ann Hematol, 2023, 102(12): 3635-3637.
6.	Ruutu T, Peczynski C, Houhou M, et al. Current incidence, severity, and management of veno-occlusive disease/sinusoidal obstruction syndrome in adult allogeneic HSCT recipients: an EBMT Transplant Complications Working Party study. Bone Marrow Transplant, 2023, 58(11): 1209-1214.
7.	Robinson SM, Mann J, Vasilaki A, et al. Pathogenesis of FOLFOX induced sinusoidal obstruction syndrome in a murine chemotherapy model. J Hepatol, 2013, 59(2): 318-326.
8.	Yang XQ, Ye J, Li X, et al. Pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome: Pathogenesis, clinical manifestations, diagnosis, treatment, and outcomes. World J Gastroenterol, 2019, 25(28): 3753-3763.
9.	凌美, 武谦虎. 土三七致肝小静脉闭塞症81例文献分析. 药物不良反应杂志, 2013, 15(5): 254-257.
10.	刘璐, 张玮, 张明, 等. 吡咯生物碱相关肝窦阻塞综合征诊断“南京标准”的初步临床验证. 中华消化杂志, 2019, 39(2): 119-123.
11.	Mohty M, Malard F, Alaskar AS, et al. Diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a refined classification from the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant, 2023, 58(7): 749-754.
12.	Valla DC. Budd-Chiari syndrome and veno-occlusive disease/sinusoidal obstruction syndrome. Gut, 2008, 57(10): 1469-1478.
13.	Zhuge Y, Liu Y, Xie W, et al. Expert consensus on the clinical management of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome. J Gastroenterol Hepatol, 2019, 34(4): 634-642.
14.	王伟, 李雪芹, 张海英, 等. 肝淀粉样变性与肝窦阻塞综合征临床及影像特征的鉴别分析. 磁共振成像, 2021, 12(2): 74-78.
15.	Putta S, Young BA, Levine JE, et al. Prognostic biomarkers for hepatic veno-occlusive disease/sinusoidal obstruction syndrome in myeloablative allogeneic hematopoietic cell transplantation: results from the blood and marrow transplant clinical trials network 1202 Study. Transplant Cell Ther, 2023, 29(3): e1-e166. e10. doi: 10.1016/j.jtct.2022.11.024.
16.	Dai F, Qiao W, Kang Z, et al. Clinical features and CT imaging analysis of hepatic sinuscase-syndrome and Budd-Chiari syndrome. Int J Gen Med, 2022, 15: 2389-2396.
17.	Zhou H, Wang YX, Lou HY, et al. Hepatic sinusoidal obstruction syndrome caused by herbal medicine: CT and MRI features. Korean J Radiol, 2014, 15(2): 218-225.
18.	Zhang W, Liu L, Zhang M, et al. Validation of the Nanjing Criteria for diagnosing pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome. J Clin Transl Hepatol, 2021, 9(3): 345-352.
19.	尚亚男, 徐浩, 郭潇, 等. 土三七致肝窦阻塞综合征的临床及CT特征研究. 医学影像学杂志, 2022, 32(8): 1317-1322.
20.	邓玉婷, 周俊英. 布加综合征诊治研究进展. 实用肝脏病杂志, 2023, 26(2): 156-159.
21.	Inchingolo R, Posa A, Mariappan M, et al. Transjugular intrahepatic portosystemic shunt for Budd-Chiari syndrome: A comprehensive review. World J Gastroenterol, 2020, 26(34): 5060-5073.
22.	Tong Y, Zhang M, Qi Z, et al. Hepatic venous occlusion type of Budd-Chiari syndrome versus pyrrolizidine alkaloid-induced hepatic sinusoidal obstructive syndrome: A multi-center retros-pective study. J Pers Med, 2023, 13(4): 603. doi: 10.3390/jpm13040603.
23.	Germani G, Dhillon A, Andreana L, et al. Histological subclassification of cirrhosis. Hepatology, 2010, 52(2): 804-805.
24.	Rubino JG, Nasirzadeh AR, van der Pol CB, et al. Quantitative and qualitative liver CT: imaging feature association with histopathologically confirmed hepatic cirrhosis. Abdom Radiol (NY), 2022, 47(7): 2314-2324.
25.	Kang JH, Kim DH, Kim SY, et al. Porto-sinusoidal vascular disease with portal hypertension versus liver cirrhosis: differences in imaging features on CT and hepatobiliary contrast-enhanced MRI. Abdom Radiol (NY), 2021, 46(5): 1891-1903.

1. Mavrikou I, Chatzidimitriou D, Skoura L, et al. Molecular advances in sinusoidal obstruction syndrome/veno-occlusive disease. Int J Mol Sci, 2023, 24(6): 5620. doi: 10.3390/ijms24065620. doi: 10.3390/ijms24065620.
2. Xu XT, Wang BH, Wang Q, et al. Idiopathic hypereosinophilic syndrome with hepatic sinusoidal obstruction syndrome: A case report and literature review. World J Gastrointest Surg, 2023, 15(7): 1532-1541.
3. Tan Y, Zheng S. Clinicopathological characteristics and diagnosis of hepatic sinusoidal obstruction syndrome caused by Tusanqi - Case report and literature review. Open Med (Wars), 2023, 18(1): 20230737. doi: 10.1515/med-2023-0737.
4. Lu F, Jia S, Lu H, et al. Primary Budd-Chiari syndrome versus sinusoidal obstruction syndrome: a review. Curr Med Res Opin, 2024, 40(2): 303-313.
5. Kriege O, Kreft A, Hauptrock B, et al. Diagnosis of sinusoidal obstruction syndrome: can biopsy be the key? Ann Hematol, 2023, 102(12): 3635-3637.
6. Ruutu T, Peczynski C, Houhou M, et al. Current incidence, severity, and management of veno-occlusive disease/sinusoidal obstruction syndrome in adult allogeneic HSCT recipients: an EBMT Transplant Complications Working Party study. Bone Marrow Transplant, 2023, 58(11): 1209-1214.
7. Robinson SM, Mann J, Vasilaki A, et al. Pathogenesis of FOLFOX induced sinusoidal obstruction syndrome in a murine chemotherapy model. J Hepatol, 2013, 59(2): 318-326.
8. Yang XQ, Ye J, Li X, et al. Pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome: Pathogenesis, clinical manifestations, diagnosis, treatment, and outcomes. World J Gastroenterol, 2019, 25(28): 3753-3763.
9. 凌美, 武谦虎. 土三七致肝小静脉闭塞症81例文献分析. 药物不良反应杂志, 2013, 15(5): 254-257.
10. 刘璐, 张玮, 张明, 等. 吡咯生物碱相关肝窦阻塞综合征诊断“南京标准”的初步临床验证. 中华消化杂志, 2019, 39(2): 119-123.
11. Mohty M, Malard F, Alaskar AS, et al. Diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a refined classification from the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant, 2023, 58(7): 749-754.
12. Valla DC. Budd-Chiari syndrome and veno-occlusive disease/sinusoidal obstruction syndrome. Gut, 2008, 57(10): 1469-1478.
13. Zhuge Y, Liu Y, Xie W, et al. Expert consensus on the clinical management of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome. J Gastroenterol Hepatol, 2019, 34(4): 634-642.
14. 王伟, 李雪芹, 张海英, 等. 肝淀粉样变性与肝窦阻塞综合征临床及影像特征的鉴别分析. 磁共振成像, 2021, 12(2): 74-78.
15. Putta S, Young BA, Levine JE, et al. Prognostic biomarkers for hepatic veno-occlusive disease/sinusoidal obstruction syndrome in myeloablative allogeneic hematopoietic cell transplantation: results from the blood and marrow transplant clinical trials network 1202 Study. Transplant Cell Ther, 2023, 29(3): e1-e166. e10. doi: 10.1016/j.jtct.2022.11.024.
16. Dai F, Qiao W, Kang Z, et al. Clinical features and CT imaging analysis of hepatic sinuscase-syndrome and Budd-Chiari syndrome. Int J Gen Med, 2022, 15: 2389-2396.
17. Zhou H, Wang YX, Lou HY, et al. Hepatic sinusoidal obstruction syndrome caused by herbal medicine: CT and MRI features. Korean J Radiol, 2014, 15(2): 218-225.
18. Zhang W, Liu L, Zhang M, et al. Validation of the Nanjing Criteria for diagnosing pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome. J Clin Transl Hepatol, 2021, 9(3): 345-352.
19. 尚亚男, 徐浩, 郭潇, 等. 土三七致肝窦阻塞综合征的临床及CT特征研究. 医学影像学杂志, 2022, 32(8): 1317-1322.
20. 邓玉婷, 周俊英. 布加综合征诊治研究进展. 实用肝脏病杂志, 2023, 26(2): 156-159.
21. Inchingolo R, Posa A, Mariappan M, et al. Transjugular intrahepatic portosystemic shunt for Budd-Chiari syndrome: A comprehensive review. World J Gastroenterol, 2020, 26(34): 5060-5073.
22. Tong Y, Zhang M, Qi Z, et al. Hepatic venous occlusion type of Budd-Chiari syndrome versus pyrrolizidine alkaloid-induced hepatic sinusoidal obstructive syndrome: A multi-center retros-pective study. J Pers Med, 2023, 13(4): 603. doi: 10.3390/jpm13040603.
23. Germani G, Dhillon A, Andreana L, et al. Histological subclassification of cirrhosis. Hepatology, 2010, 52(2): 804-805.
24. Rubino JG, Nasirzadeh AR, van der Pol CB, et al. Quantitative and qualitative liver CT: imaging feature association with histopathologically confirmed hepatic cirrhosis. Abdom Radiol (NY), 2022, 47(7): 2314-2324.
25. Kang JH, Kim DH, Kim SY, et al. Porto-sinusoidal vascular disease with portal hypertension versus liver cirrhosis: differences in imaging features on CT and hepatobiliary contrast-enhanced MRI. Abdom Radiol (NY), 2021, 46(5): 1891-1903.

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