A Comparative Study of Ultrasonography and CT Venography in the Diagnosis of Budd‐Chiari Syndrome

ABSTRACT Objectives Budd‐Chiari syndrome (BCS) is characterized by hepatic venous outflow obstruction, from hepatic veins to the junction of the inferior vena cava (IVC) and the right atrium. Accurate diagnosis of BCS is essential for patient prognosis and management. This study aims to compare the diagnostic efficacy of ultrasound (US) and computed tomography venography (CTV) in diagnosing BCS. Materials and Methods A retrospective analysis was conducted, of which 250 suspected BCS patients underwent both US and CTV examinations from January 2010 to December 2021. Diagnostic criteria were based on imaging signs of venous narrowing or occlusion. Statistical analyses were performed using SPSS 25.0 software. Results Both US and CTV exhibited high diagnostic accuracy for BCS, with sensitivities of 87% and 86%, specificities of 72% and 78%, positive predictive values (PPV) of 95% and 96%, negative predictive values (NPV) of 48% and 48%, and accuracies of 85% and 85%, respectively. Subgroup analysis revealed that CTV outperformed US in diagnosing type I BCS, while US demonstrated superior diagnostic accuracy for type II BCS. No significant difference was observed between US and CTV in diagnosing type III BCS. Conclusion Both US and CTV demonstrate high diagnostic accuracy for BCS, with distinct advantages across BCS subtypes. US is favored for its non‐invasiveness and ease of use, especially in pediatric patients. Further multicenter prospective studies are warranted to validate these findings and explore additional non‐invasive imaging options.