In Reply to: Case 0498_09 --Hepatic vein occlusion posted by Editor on March 31, 1998 at 14:49:30:
3) Are there any additional diagnostic studies that should be performed?
The MRI is not conclusive - T1 weighted gad enhanced imaging is not a well validated methods for identifying hepatic veins (or any others for that matter). Much better would be conventional 2D time of flight (without the surface coil) and if that failed breathhold gad enhanced 3D MRA. See SCVIR Syllabus 8, chapter 14 for a full discussion.
I have had one case where 2D TOF alone was successful where ultrasound, and attempted TIPS had all failed to show the hepatic veins - subsequent TIPS was sucessful.