{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:31:03Z","timestamp":1783042263911,"version":"3.54.6"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2016,11,29]],"date-time":"2016-11-29T00:00:00Z","timestamp":1480377600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2016,11,29]],"date-time":"2016-11-29T00:00:00Z","timestamp":1480377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hepatic sinusoidal obstruction syndrome (HSOS) can be caused by pyrrolizidine alkaloids(PAs)-containing herbals. Since PAs exposure is obscure and clinical presentation of HSOS is unspecific, it is challenge to establish the diagnosis of PAs-induced HSOS. Gynura segetum is one of the most wide-use herbals containing PAs. The aim of our study is to describe the features of contrast-enhanced computed tomography (CT) in gynura segetum-induced HSOS, and then determine diagnostic performance of radiological signs. We retrospectively analyzed medical records and CT images of HSOS patients (71 cases) and the controls (222 cases) enrolled from January 1, 2008, to Oct 31, 2015. The common findings of contrast CT in PAs-induced HSOS included: ascites (100%), hepatomegaly (78.87%), gallbladder wall thickening (86.96%), pleural effusion (70.42%), hepatic vein narrowing (87.32%), patchy liver enhancement (92.96%), and heterogeneous hypoattenuation (100%); of these signs, patchy enhancement and heterogeneous hypoattenuation were valuable features. Then, the result of diagnostic performance demonstrated that contrast CT possessed better performance in diagnosing PAs-induced HSOS compared with various parameters of Seattle criteria. In conclusion, the patients with PAs-induced HSOS display distinct radiologic features at CT-scan, which reveals that contrast-enhanced CT provides an effective noninvasive method for diagnosing PAs-induced HSOS.<\/jats:p>","DOI":"10.1038\/srep37998","type":"journal-article","created":{"date-parts":[[2016,11,29]],"date-time":"2016-11-29T10:08:10Z","timestamp":1480414090000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Diagnostic performance of Contrast-enhanced CT in Pyrrolizidine Alkaloids-induced Hepatic Sinusoidal Obstructive Syndrome"],"prefix":"10.1038","volume":"6","author":[{"given":"Xuefeng","family":"Kan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Rong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwen","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhu","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohua","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,11,29]]},"reference":[{"key":"BFsrep37998_CR1","doi-asserted-by":"publisher","first-page":"S25","DOI":"10.1016\/S0168-8278(12)60004-X","volume":"56","author":"A Plessier","year":"2012","unstructured":"Plessier, A., Rautou, P. E. & Valla, D. C. Management of hepatic vascular diseases. J Hepatol 56 Suppl 1, S25\u201338 (2012).","journal-title":"J Hepatol"},{"key":"BFsrep37998_CR2","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1002\/hep.22772","volume":"49","author":"LD DeLeve","year":"2009","unstructured":"DeLeve, L. D., Valla, D. C. & Garcia-Tsao, G. Vascular disorders of the liver. Hepatology 49, 1729\u20131764 (2009).","journal-title":"Hepatology"},{"key":"BFsrep37998_CR3","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/S0168-8278(03)00231-9","volume":"39","author":"M Chojkier","year":"2003","unstructured":"Chojkier, M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 39, 437\u2013446 (2003).","journal-title":"J Hepatol"},{"key":"BFsrep37998_CR4","doi-asserted-by":"publisher","first-page":"218","DOI":"10.3348\/kjr.2014.15.2.218","volume":"15","author":"H Zhou","year":"2014","unstructured":"Zhou, H., Wang, Y. X., Lou, H. Y., Xu, X. J. & Zhang, M. M. Hepatic sinusoidal obstruction syndrome caused by herbal medicine: CT and MRI features. Korean J Radiol 15, 218\u2013225 (2014).","journal-title":"Korean J Radiol"},{"key":"BFsrep37998_CR5","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/j.jhep.2010.07.031","volume":"54","author":"G Lin","year":"2011","unstructured":"Lin, G. et al. Hepatic sinusoidal obstruction syndrome associated with consumption of Gynura segetum. J Hepatol 54, 666\u2013673 (2011).","journal-title":"J Hepatol"},{"key":"BFsrep37998_CR6","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1751-2980.2011.00552.x","volume":"13","author":"H Gao","year":"2012","unstructured":"Gao, H., Li, N., Wang, J. Y., Zhang, S. C. & Lin, G. Definitive diagnosis of hepatic sinusoidal obstruction syndrome induced by pyrrolizidine alkaloids. J Dig Dis 13, 33\u201339 (2012).","journal-title":"J Dig Dis"},{"key":"BFsrep37998_CR7","doi-asserted-by":"publisher","first-page":"e942","DOI":"10.1097\/MD.0000000000000942","volume":"94","author":"X Wang","year":"2015","unstructured":"Wang, X., Qi, X. & Guo, X. Tusanqi-Related Sinusoidal Obstruction Syndrome in China: A Systematic Review of the Literatures. Medicine (Baltimore) 94, e942 (2015).","journal-title":"Medicine (Baltimore)"},{"key":"BFsrep37998_CR8","doi-asserted-by":"publisher","first-page":"4861","DOI":"10.2147\/DDDT.S87858","volume":"9","author":"H Gao","year":"2015","unstructured":"Gao, H. et al. Blood pyrrole-protein adducts as a diagnostic and prognostic index in pyrrolizidine alkaloid-hepatic sinusoidal obstruction syndrome. Drug Des Devel Ther 9, 4861\u20134868 (2015).","journal-title":"Drug Des Devel Ther"},{"key":"BFsrep37998_CR9","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1007\/s00261-001-0097-5","volume":"27","author":"KJ Mortele","year":"2002","unstructured":"Mortele, K. J., Van Vlierberghe, H., Wiesner, W. & Ros, P. R. Hepatic veno-occlusive disease: MRI findings. Abdom Imaging 27, 523\u2013526 (2002).","journal-title":"Abdom Imaging"},{"key":"BFsrep37998_CR10","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1111\/j.1872-034X.2011.00918.x","volume":"42","author":"XW Wu","year":"2012","unstructured":"Wu, X. W. et al. Hepatic veno-occlusive disease after taking Gynura Rhizome: The value of multidetector computed tomography in diagnosing the disease and evaluating the clinical therapeutic effect. Hepatol Res 42, 304\u2013309 (2012).","journal-title":"Hepatol Res"},{"key":"BFsrep37998_CR11","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1097\/00007890-198712000-00011","volume":"44","author":"RJ Jones","year":"1987","unstructured":"Jones, R. J. et al. Venoocclusive disease of the liver following bone marrow transplantation. Transplantation 44, 778\u2013783 (1987).","journal-title":"Transplantation"},{"key":"BFsrep37998_CR12","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1002\/hep.1840040121","volume":"4","author":"GB McDonald","year":"1984","unstructured":"McDonald, G. B., Sharma, P., Matthews, D. E., Shulman, H. M. & Thomas, E. D. Venocclusive disease of the liver after bone marrow transplantation: diagnosis, incidence, and predisposing factors. Hepatology 4, 116\u2013122 (1984).","journal-title":"Hepatology"},{"key":"BFsrep37998_CR13","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1038\/bmt.2016.130","volume":"51","author":"M Mohty","year":"2016","unstructured":"Mohty, M. et al. Revised diagnosis and severity criteria for sinusoidal obstruction syndrome\/veno-occlusive disease in adult patients: a new classification from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 51, 906\u2013912 (2016).","journal-title":"Bone Marrow Transplant"},{"key":"BFsrep37998_CR14","doi-asserted-by":"publisher","first-page":"4304","DOI":"10.1200\/JCO.2008.16.1893","volume":"26","author":"J Ward","year":"2008","unstructured":"Ward, J. et al. Sinusoidal obstructive syndrome diagnosed with superparamagnetic iron oxide-enhanced magnetic resonance imaging in patients with chemotherapy-treated colorectal liver metastases. J Clin Oncol 26, 4304\u20134310 (2008).","journal-title":"J Clin Oncol"},{"key":"BFsrep37998_CR15","doi-asserted-by":"publisher","first-page":"1912","DOI":"10.3748\/wjg.v13.i13.1912","volume":"13","author":"UD Bayraktar","year":"2007","unstructured":"Bayraktar, U. D., Seren, S. & Bayraktar, Y. Hepatic venous outflow obstruction: three similar syndromes. World J Gastroenterol 13, 1912\u20131927 (2007).","journal-title":"World J Gastroenterol"},{"key":"BFsrep37998_CR16","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1007\/s00330-011-2333-x","volume":"22","author":"NY Shin","year":"2012","unstructured":"Shin, N. Y. et al. Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases. Eur Radiol 22, 864\u2013871 (2012).","journal-title":"Eur Radiol"},{"key":"BFsrep37998_CR17","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1148\/radiol.13131810","volume":"271","author":"NY Han","year":"2014","unstructured":"Han, N. Y. et al. Chemotherapy-induced focal hepatopathy in patients with gastrointestinal malignancy: gadoxetic acid\u2013enhanced and diffusion-weighted MR imaging with clinical-pathologic correlation. Radiology 271, 416\u2013425 (2014).","journal-title":"Radiology"},{"key":"BFsrep37998_CR18","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.ejrad.2006.11.004","volume":"61","author":"A Erden","year":"2007","unstructured":"Erden, A. Budd-Chiari syndrome: a review of imaging findings. Eur J Radiol 61, 44\u201356 (2007).","journal-title":"Eur J Radiol"},{"key":"BFsrep37998_CR19","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1148\/radiology.165.2.3659365","volume":"165","author":"D Mathieu","year":"1987","unstructured":"Mathieu, D. et al. Budd-Chiari syndrome: dynamic CT. Radiology 165, 409\u2013413 (1987).","journal-title":"Radiology"},{"key":"BFsrep37998_CR20","doi-asserted-by":"publisher","first-page":"2071","DOI":"10.1007\/s00330-006-0537-2","volume":"17","author":"O Buckley","year":"2007","unstructured":"Buckley, O. et al. Imaging of Budd-Chiari syndrome. Eur Radiol 17, 2071\u20132078 (2007).","journal-title":"Eur Radiol"},{"key":"BFsrep37998_CR21","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/j.ejso.2009.01.015","volume":"35","author":"TR O\u2019Rourke","year":"2009","unstructured":"O\u2019Rourke, T. R. et al. Accuracy of liver-specific magnetic resonance imaging as a predictor of chemotherapy-associated hepatic cellular injury prior to liver resection. Eur J Surg Oncol 35, 1085\u20131091 (2009).","journal-title":"Eur J Surg Oncol"},{"key":"BFsrep37998_CR22","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.2214\/AJR.05.0539","volume":"186","author":"SM Erturk","year":"2006","unstructured":"Erturk, S. M. et al. CT features of hepatic venoocclusive disease and hepatic graft-versus-host disease in patients after hematopoietic stem cell transplantation. AJR Am J Roentgenol 186, 1497\u20131501 (2006).","journal-title":"AJR Am J Roentgenol"},{"key":"BFsrep37998_CR23","doi-asserted-by":"publisher","first-page":"6422","DOI":"10.3748\/wjg.v21.i20.6422","volume":"21","author":"T Shen","year":"2015","unstructured":"Shen, T., Feng, X. W., Geng, L. & Zheng, S. S. Reversible sinusoidal obstruction syndrome associated with tacrolimus following liver transplantation. World J Gastroenterol 21, 6422\u20136426 (2015).","journal-title":"World J Gastroenterol"},{"key":"BFsrep37998_CR24","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/S0168-8278(01)00095-2","volume":"35","author":"D de las Heras","year":"2001","unstructured":"de las Heras, D. & Pages, M. Abnormal hepatic enhancement on CT in congestive heart failure. J Hepatol 35, 431 (2001).","journal-title":"J Hepatol"},{"key":"BFsrep37998_CR25","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1148\/radiology.170.3.2916031","volume":"170","author":"HC Holley","year":"1989","unstructured":"Holley, H. C., Koslin, D. B., Berland, L. L. & Stanley, R. J. Inhomogeneous enhancement of liver parenchyma secondary to passive congestion: contrast-enhanced CT. Radiology 170, 795\u2013800 (1989).","journal-title":"Radiology"},{"key":"BFsrep37998_CR26","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1111\/1751-2980.12112","volume":"15","author":"JY Wang","year":"2014","unstructured":"Wang, J. Y. & Gao, H. Tusanqi and hepatic sinusoidal obstruction syndrome. J Dig Dis 15, 105\u2013107 (2014).","journal-title":"J Dig Dis"},{"key":"BFsrep37998_CR27","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/S0168-8278(02)00434-8","volume":"38","author":"HL Janssen","year":"2003","unstructured":"Janssen, H. L. et al. Budd-Chiari syndrome: a review by an expert panel. J Hepatol 38, 364\u2013371 (2003).","journal-title":"J Hepatol"},{"key":"BFsrep37998_CR28","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1038\/ncpgasthep0143","volume":"2","author":"M Senzolo","year":"2005","unstructured":"Senzolo, M., Cholongitas, E. C., Patch, D. & Burroughs, A. K. Update on the classification, assessment of prognosis and therapy of Budd-Chiari syndrome. Nat Clin Pract Gastroenterol Hepatol 2, 182\u2013190 (2005).","journal-title":"Nat Clin Pract Gastroenterol Hepatol"},{"key":"BFsrep37998_CR29","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1097\/00029330-200701020-00019","volume":"120","author":"XM Zhang","year":"2007","unstructured":"Zhang, X. M. & Li, Q. L. Etiology, treatment, and classification of Budd-Chiari syndrome. Chin Med J (Engl) 120, 159\u2013161 (2007).","journal-title":"Chin Med J (Engl)"},{"key":"BFsrep37998_CR30","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/S1665-2681(19)30865-8","volume":"13","author":"F Liu","year":"2014","unstructured":"Liu, F. et al. Evaluation of tumor markers for the differential diagnosis of benign and malignant ascites. Ann Hepatol 13, 357\u2013363 (2014).","journal-title":"Ann Hepatol"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep37998.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep37998","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep37998.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:50:54Z","timestamp":1672879854000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep37998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,29]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,12,23]]}},"alternative-id":["BFsrep37998"],"URL":"https:\/\/doi.org\/10.1038\/srep37998","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,29]]},"assertion":[{"value":"24 August 2016","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2016","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2016","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"37998"}}