Table 1 Different imaging modalities for SOS and their findings
From: Noninvasive imaging diagnosis of sinusoidal obstruction syndrome: a pictorial review
Major imaging modalities in diagnosis of SOS | |||
|---|---|---|---|
Modality | Role | Imaging features of SOS | |
US | B-mode US | Screening and early differential diagnosis, especially in asymptomatic or late-onset cases | Hepatosplenomegaly, gallbladder wall thickening > 6 mm, portal diameter > 12 mm, hepatic vein diameter < 3 mm, and indirect signs suggest portal hypertension such as ascites and visualization of collateral circulatory |
|  | Doppler US | Surveillance and diagnostic, revealing morphologic changes, and flow velocity fluctuation | Hepatic vein diameter < 3 mm, collateral circulatory visualization, demodulation of portal vein flow, spectral density decline, congestion index < 0.1, portal vein flow < 10 cm/s, hepatic artery resistive index > 0.75, and monophasic flow in hepatic veins |
| Â | CEUS | Rapid diagnosis and differential diagnosis | Diffuse or geographic enhancement of hepatic parenchyma, with a scattering of hypoecho areas; hypoechoic lesion with hypervascularity in the arterial phase and a rapid wash-out appearance in the portal phase |
CT | Â | Diagnostic | Cloverleaf or claw-like shapes; lesion with peritumoral enhancement and central low attenuation |
MRI | All gadolinium-enhanced MRI | Diagnostic | Cloverleaf or claw-like shapes; peritumoral enhancement lesion with central low-signal intensity |
| Â | Gadoxetate-enhanced MRI | Diagnostic and provide information about liver function | Diffuse or geographic hypo-intensity |
| Â | SWI | Differential diagnosis | Geographic or nodular hypo-intensity |