Hepatic Venous Occlusion Type of Budd–Chiari Syndrome versus Pyrrolizidine Alkaloid-Induced Hepatic Sinusoidal Obstructive Syndrome: A Multi-Center Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Clinical Data
2.2. Enhanced CT and MRI
2.3. Doppler Ultrasonography
2.4. Digital Subtraction Angiography
2.5. Statistics
3. Results
3.1. Clinical Presentation
3.2. Laboratory Tests
3.3. Imaging Findings
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | BCS-HV (n = 139) | PA-HSOS (n = 257) | p Value |
---|---|---|---|
Age (year, mean ± SD) | 43.00 ± 13.08 | 62.75 ± 9.68 | <0.001 |
Male, n (%) | 67 (48.20) | 132 (51.40) | 0.549 |
Course of disease (months, m (Q1~Q3)) | 3 (1.00–24.00) | 1.00 (0.67–2.00) | <0.001 |
≤6 months, n (%) | 85 (61.20) | 249 (96.90) | <0.001 |
Abdominal distension, n (%) | 89 (64.00) | 257 (100) | <0.001 |
Abdominal pain, n (%) | 24 (17.30) | 68 (26.10) | 0.047 |
Ascites | 97 (69.78) | 256 (99.60) | <0.001 |
None, n (%) | 43 (31.20) | 1 (0.40) | <0.001 |
Mild, n (%) | 37 (26.80) | 11 (4.30) | <0.001 |
Moderate to severe, n (%) | 58 (42.00) | 245 (95.30) | <0.001 |
Varices of abdominal wall, n (%) | 13 (9.40) | 11 (4.30) | 0.044 |
Jaundice, n (%) | 37 (26.60) | 115 (44.70) | <0.001 |
Lower extremity edema, n (%) | 28 (20.10) | 66 (25.70) | 0.217 |
History of PA intake, n (%) | 0 | 210(81.71) | <0.001 |
Variables | BCS-HV (n = 139) | PA-HSOS (n = 257) | p Value |
---|---|---|---|
WBC count, (×109/L, m (Q1~Q3)) | 4.70 (3.20–6.32) | 6.00 (4.80–7.90) | <0.001 |
HB (g/L, mean ± SD) | 120.14 ± 29.92 | 143.78 ± 20.13 | <0.001 |
PLT count, (×1012/L, m (Q1~Q3)) | 117.00 (78.00–185.00) | 101.00 (72.00–134.50) | 0.001 |
ALT (U/L, m (Q1~Q3)) | 23.00 (16.00–32.00) | 48.80 (25.15–101.85) | <0.001 |
AST (U/L, m (Q1~Q3)) | 28.00 (21.00–40.00) | 64.10 (40.00–107.45) | <0.001 |
ALP (U/L, m (Q1~Q3)) | 111.00 (78.00–149.00) | 128.80 (97.40–174.05) | 0.001 |
Albumin (g/L, mean ± SD) | 36.45 ± 5.64 | 32.70 ± 3.52 | <0.001 |
TBil (μmoI/L, m (Q1~Q3)) | 26.20 (16.06–45.33) | 37.60 (25.40–55.65) | <0.001 |
SCr (μmoI/L, m (Q1~Q3)) | 57.00 (50.50–68.60) | 72.00 (59.00–88.50) | <0.001 |
PT (s, m (Q1~Q3)) | 13.90 (12.50–15.90) | 15.20 (13.70–17.55) | <0.001 |
APTT (s, m (Q1~Q3)) | 38.70 (31.50–62.00) | 35.00 (30.15–43.95) | 0.001 |
INR (m (Q1~Q3)) | 1.21 (1.09–1.37) | 1.31 (1.19–1.52) | <0.001 |
Fib (g/L, m (Q1~Q3)) | 2.42 (2.00–2.86) | 2.10 (1.70–2.70) | <0.001 |
Child–Pugh scores (mean ± SD) | 7.43 ± 1.98 | 9.15 ± 1.48 | <0.001 |
Child–Pugh class | |||
A, n (%) | 51 (36.70%) | 2 (0.80%) | |
B, n (%) | 65 (46.80%) | 152 (59.10%) | |
C, n (%) | 23 (16.50%) | 103 (40.10%) |
Variables | BCS-HV | PA-HSOS | p Value |
---|---|---|---|
Portal vein thrombosis, % (n/N) | 4.4% (6/136) | 11.70%(30/257) | 0.018 |
Localized stenosis or occlusion of the hepatic veins, % (n/N) | 100.00% (130/130) | 1.20% (3/256) | <0.001 |
Imaging manifestations of cirrhosis, % (n/N) | 47.10% (65/138) | 2.00% (5/256) | <0.001 |
Hepatomegaly, % (n/N) | 56.20% (73/130) | 67.10% (163/243) | 0.037 |
Splenomegaly, % (n/N) | 63.80% (78/130) | 16.10% (39/242) | <0.001 |
Collateral circulation of hepatic veins, % (n/N) | 73.90% (99/134) | 0 | <0.001 |
Diameter of left hepatic vein, (cm, mean ± SD, n/N) | 0.70 (0.50~1.09) (78/134) | 0.39 (0.30~0.45) (156/160) | <0.001 |
Diameter of middle hepatic vein, (cm, mean ± SD, n/N) | 0.70 (0.50~1.10) (70/134) | 0.42 (0.35~0.49) (160/160) | <0.001 |
Diameter of right hepatic vein, (cm, mean ± SD, n/N) | 0.80 (0.50~1.10) (54/134) | 0.42 (0.36~0.49) (159/160) | <0.001 |
Diameter of portal vein, (cm, mean ± SD, n/N) | 1.19 ± 0.27 (112/136) | 1.00 ± 0.16 (243/257) | <0.001 |
Portal vein blood flow velocity, (cm/s, mean ± SD, n/N) | 21.84 ± 9.22 (54/136) | 15.74 ± 7.99 (238/238) | <0.001 |
Diameter of splenic vein, (cm, mean ± SD, n/N) | 0.89 ± 0.29 (72/136) | 0.60 ± 0.12 (230/230) | 0.002 |
Splenic vein blood flow velocity, (cm/s, mean ± SD, n/N) | 18.78 ± 9.42 (30/136) | 13.47 ± 6.26 (230/230) | 0.001 |
Patchy liver enhancement, % (n/N) | 78.46% (102/130) | 92.66% (164/177) | <0.001 |
Enlarged caudate lobe of the liver, n/N (%) | 47.70% (62/130) | 0 | <0.001 |
Early strengthening nodules in the liver, n/N (%) | 8.50% (11/129) | 0 | <0.001 |
Narrowed inferior vena cava, n/N (%) | 55.20% (69/125) | 44.20% (80/177) | 0.087 |
Esophageal varicose veins, n/N (%) | 64.00% (80/125) | 21.20% (38/179) | <0.001 |
Variables | BCS-HV | PA-HSOS | ||||
---|---|---|---|---|---|---|
DUS | CT/MRI | p Value | DUS | CT/MRI | p Value | |
Hepatic venous stenosis or occlusion, % (n/N) | 86.29% (107/124) | 4.55% (5/110) | <0.001 | 1.88% (3/160) | 2.83% (5/177) | 0.726 |
Unclear display of hepatic vein, % (n/N) | 12.90% (16/124) | 94.55% (104/110) | <0.001 | 0.62% (1/160) | 97.18% (172/177) | <0.001 |
Collateral circulation of hepatic veins, % (n/N) | 70.97% (88/124) | 4.55% (5/110) | <0.001 | 0 | 0 | / |
Enlarged caudate lobe, % (n/N) | / | 47.27% (52/110) | / | / | 0 | / |
Early strengthening nodules, % (n/N) | / | 8.18% (9/110) | / | / | 0 | / |
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Tong, Y.; Zhang, M.; Qi, Z.; Wu, W.; Chen, J.; He, F.; Han, H.; Ding, P.; Wang, G.; Zhuge, Y. Hepatic Venous Occlusion Type of Budd–Chiari Syndrome versus Pyrrolizidine Alkaloid-Induced Hepatic Sinusoidal Obstructive Syndrome: A Multi-Center Retrospective Study. J. Pers. Med. 2023, 13, 603. https://doi.org/10.3390/jpm13040603
Tong Y, Zhang M, Qi Z, Wu W, Chen J, He F, Han H, Ding P, Wang G, Zhuge Y. Hepatic Venous Occlusion Type of Budd–Chiari Syndrome versus Pyrrolizidine Alkaloid-Induced Hepatic Sinusoidal Obstructive Syndrome: A Multi-Center Retrospective Study. Journal of Personalized Medicine. 2023; 13(4):603. https://doi.org/10.3390/jpm13040603
Chicago/Turabian StyleTong, Yaru, Ming Zhang, Zexue Qi, Wei Wu, Jinjun Chen, Fuliang He, Hao Han, Pengxu Ding, Guangchuan Wang, and Yuzheng Zhuge. 2023. "Hepatic Venous Occlusion Type of Budd–Chiari Syndrome versus Pyrrolizidine Alkaloid-Induced Hepatic Sinusoidal Obstructive Syndrome: A Multi-Center Retrospective Study" Journal of Personalized Medicine 13, no. 4: 603. https://doi.org/10.3390/jpm13040603