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Objective <p>To investigate the clinical value of Doppler ultrasound in the rapid evaluation of therapeutic efficacy of angioplasty and prediction of recurrence in patients with Budd–Chiari syndrome (BCS).</p> Materials and methods <p>A retrospective study was conducted on BCS patients who underwent angioplasty at our hospital between January 2015 and December 2024. Ultrasound examinations were performed preoperatively and within 7 days postoperatively to compare changes in ultrasound parameters. Follow-up ultrasounds were conducted postoperatively. Differences in ultrasound parameters between recurrence and non-recurrence groups were analyzed to identify indicators for the rapid evaluation of recurrence. Cox regression analysis was used to identify independent risk factors for recurrence.</p> Results <p>A total of 99 patients (51 males, 48 females; mean age 39.38 ± 12.20 years) were included. Postoperative ultrasound showed significant increases in portal vein (PV) diameter (<i>p</i> = 0.019) and velocity (<i>p</i> &lt; 0.001), while caudate lobe thickness (<i>p</i> = 0.016), spleen length (<i>p</i> = 0.004), spleen thickness (<i>p</i> = 0.012), and ascites depth (<i>p</i> &lt; 0.001) decreased. During follow-up, PV velocity slightly decreased in the non-recurrence group (25.1 cm/s vs 28.3 cm/s, <i>p</i> = 0.018), while it significantly declined in the recurrence group (21.4 cm/s vs 30.2 cm/s, <i>p</i> &lt; 0.001). The median velocity decline was greater in the recurrence group (−7 cm/s vs −1 cm/s, <i>p</i> = 0.003). Multivariate Cox regression identified postoperative paraumbilical vein dilation (HR: 2.970, 95% CI: 1.232–7.156, <i>p</i> = 0.015) and preoperative high D-dimer levels (HR: 1.258, 95% CI: 1.079–1.466, <i>p</i> = 0.003) as independent risk factors for recurrence.</p> Conclusion <p>Doppler ultrasound is a valuable tool for the rapid evaluation of hepatic drainage during follow-up, particularly through monitoring PV velocity. Postoperative paraumbilical vein dilation may serve as a predictive marker for future recurrence.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Evaluating angioplasty efficacy in BCS is complex and time-consuming, while predicting recurrence with Doppler ultrasound is challenging</i>.</p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>During follow-up, ultrasound monitoring of portal vein flow velocity reflects hepatic drainage, while postoperative paraumbilical vein dilation was an independent risk factor for recurrence</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Doppler ultrasound allowed for rapid evaluation of postoperative hepatic drainage in BCS patients during follow-up, optimizes examination protocols, predicts future vascular recurrence, and establishes a foundation for individualized follow-up and treatment</i>.</p> Graphical Abstract <p></p>

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The application of Doppler ultrasound in evaluating angioplasty outcomes and predicting recurrence in Budd–Chiari syndrome

  • 期刊论文

  • 发表日期：

    2026年3月12日

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  • Bo Jiang,
  • Ye Li,
  • Xiang Fei,
  • LianHua Zhu,
  • Bing Yuan,
  • JieYu Yan,
  • YuKun Luo

摘要

Objective

To investigate the clinical value of Doppler ultrasound in the rapid evaluation of therapeutic efficacy of angioplasty and prediction of recurrence in patients with Budd–Chiari syndrome (BCS).

Materials and methods

A retrospective study was conducted on BCS patients who underwent angioplasty at our hospital between January 2015 and December 2024. Ultrasound examinations were performed preoperatively and within 7 days postoperatively to compare changes in ultrasound parameters. Follow-up ultrasounds were conducted postoperatively. Differences in ultrasound parameters between recurrence and non-recurrence groups were analyzed to identify indicators for the rapid evaluation of recurrence. Cox regression analysis was used to identify independent risk factors for recurrence.

Results

A total of 99 patients (51 males, 48 females; mean age 39.38 ± 12.20 years) were included. Postoperative ultrasound showed significant increases in portal vein (PV) diameter (p = 0.019) and velocity (p < 0.001), while caudate lobe thickness (p = 0.016), spleen length (p = 0.004), spleen thickness (p = 0.012), and ascites depth (p < 0.001) decreased. During follow-up, PV velocity slightly decreased in the non-recurrence group (25.1 cm/s vs 28.3 cm/s, p = 0.018), while it significantly declined in the recurrence group (21.4 cm/s vs 30.2 cm/s, p < 0.001). The median velocity decline was greater in the recurrence group (−7 cm/s vs −1 cm/s, p = 0.003). Multivariate Cox regression identified postoperative paraumbilical vein dilation (HR: 2.970, 95% CI: 1.232–7.156, p = 0.015) and preoperative high D-dimer levels (HR: 1.258, 95% CI: 1.079–1.466, p = 0.003) as independent risk factors for recurrence.

Conclusion

Doppler ultrasound is a valuable tool for the rapid evaluation of hepatic drainage during follow-up, particularly through monitoring PV velocity. Postoperative paraumbilical vein dilation may serve as a predictive marker for future recurrence.

Key Points

Question Evaluating angioplasty efficacy in BCS is complex and time-consuming, while predicting recurrence with Doppler ultrasound is challenging.

Findings During follow-up, ultrasound monitoring of portal vein flow velocity reflects hepatic drainage, while postoperative paraumbilical vein dilation was an independent risk factor for recurrence.

Clinical relevance Doppler ultrasound allowed for rapid evaluation of postoperative hepatic drainage in BCS patients during follow-up, optimizes examination protocols, predicts future vascular recurrence, and establishes a foundation for individualized follow-up and treatment.

Graphical Abstract