[en] Objective: To explore the differences of clinical features and magnetic resonance imaging (MRI) manifestations between acute and chronic Budd-Chiari syndrome (BCS) in Chinese patients. Methods: The clinical data of MRI materials of 78 BCS patients, who were admitted to Zhejiang Hospital of China to receive treatment, were retrospectively analyzed. Based on the course of disease ≤ 6 months or > 6 months, the patients were divided into acute group (n = 32) and chronic group (n = 46). The clinical features and MRI manifestations were compared between the two groups. Results: In chronic group the patients were older than those in the acute group;the incidences of varicose vein of lower limb, lower limb swelling, lower extremity hyperpigmentation, subcutaneous varicose vein of abdominal wall were higher than those in the acute group; while the serum levels of hepatic function indexes, including ALT, AST and TBIL, were lower than those in the acute group; and the differences were statistically significant between the two groups (P < 0.05). When compared with the acute group, in the chronic group MRI showed less amount of ascites, lower incidence of liver enlargement, higher incidence of hepatic caudate lobe enlargement, more intrahepatic nodules, and higher incidence of intrahepatic-extrahepatic communicating branches and accessory hepatic veins;the differences in the above indexes between the two groups were statistically significant (P < 0.05). The main type of BCS in the acute group was hepatic vein type, while the main type of BCS in the chronic group was mixed type. On contrast-enhanced MRI, inhomogeneous hepatic parenchymal enhancement was often observed in the acute group, while homogeneous hepatic parenchymal enhancement was usually seen in the chronic group. Conclusion: Obvious differences in clinical features and MRI manifestations exist between acute and chronic BCS in Chinese patients. Understanding of these features and manifestations is helpful for making accurate staging and clinical diagnosis and treatment of BCS. (authors)