Meso-atrial Shunt for Budd-Chiari Syndrome: Evaluation of Patency by Magnetic Resonance Angiography, with Color Doppler Ultrasound and Angiographic Correlation

We report the case of a boy with Budd-Chiari syndrome. At 3 years of age a meso-atrial shunt was inserted for thrombosis of the hepatic veins with associated inferior vena cava occlusion by an enlarged caudate lobe. Seven uneventful years later, the patient was reassessed because of concern about insufficient length of the synthetic shunt. Ultrasound with color Doppler imaging (CDI) and magnetic resonance imaging (MRI) with magnetic resonance angiography (MRA) clearly depicted a patent graft, without kinking, stenosis or other sign of graft dysfunction. Conventional selective angiography confirmed the patency of the shunt. MRI with MRA and CDI are less invasive and less expensive than conventional angiography and might replace this technique for assessment of meso-atrial shunt patency.