布-加综合征下腔静脉病变类型与内支架的选择

目的探讨布－加综合征下腔静脉病变类型与内支架选择的关系,方法应用PTA及PTSA治疗BCS186例,术前应用彩色Doppler常规检查,选择内支架按以下要求;（1）内支架直径应超过下腔静脉病变远端扩张处直径1．0cm;（2）有下腔静脉血栓者,选择两组支架,一组压血栓,一组扩张病变;（3）为避免肝静脉开口受压,可选择改良血管内支架,结果 收治的186例患者中,149例行PTA,48例行PTSA（包括11例PTA后复发者）,11例患者有不同类型并发症,余患者随访1－10年疗效良好,结论 依据BCS病变类型准确选择不同内支架疗效良好。     

介入治疗布-加综合征致肝静脉再阻塞的原因及治疗

布 -加综合征 (Budd Chiarisyndrome ,BCS)治疗困难 ,以往多采用手术治疗 ,手术难度大 ,风险大。我院自1988年始开展BCS综合治疗的研究 ,共治疗各型BCS6 2 2例 ,其中 2 6 7例行介入治疗。自 1996年 8月～ 2 0 0 2年 12月 ,有 6例在经皮经腔球囊扩张成形并内支架置入术后因肝静脉再阻塞而复发 ,现就治疗失效原因及治疗方法分析如下。1　临床资料1 1　一般资料　本组男 4例 ,女 2例 ;年龄 2 9～ 5 1岁 ,平均 37 4岁。其中 3例行下腔静脉破膜扩张并内支架置入术后 ,3例行多支架压栓治疗并内支架置入术后 ,均采用国产Z形金属内支架。首次…     

布-加综合征1例诊断体会

布一加综合征（Bucld—Chiari Syndrome，BCS），即肝静脉／肝段下腔静脉阻塞综合征。是指发生在肝脏小叶下静脉以上、右心房入口处以下肝静脉主干和（或）肝段下腔静脉任何性质的阻塞，使肝脏出现肝窦淤血、出血、坏死和纤维化等病理变化。最终导致窦后性门静脉高压症的一组临床综合征。现将我们收治的1例报告如下。     

64排螺旋CT对下腔静脉阻塞布-加综合征的诊断价值

目的：分析在下腔静脉阻塞布-加综合征（Budd-Chiari syndrome,BCS）诊断中应用64排螺旋CT的临床价值。方法：选取邳州市中医院在2019年1月—2021年12月期间收治的46例下腔静脉阻塞BCS患者为研究对象,针对入院患者均予以64排螺旋CT平扫/动态增强扫描、数字减影血管造影（digital substraction angiography,DSA）检查,分别观察患者的影像表现。结果：采取64排螺旋CT平扫及动态增强扫描能够对下腔静脉阻塞BCS做出较为准确的诊断,且对比肝静脉狭窄、侧支循环征象与DSA检查无显著差异（P>0.05）。结论：在BCS诊断中,应用64排螺旋CT及DSA均能够较为直观、准确地对下腔静脉阻塞BCS患者下腔静脉阻塞部位、范围、性质、肝脏内变化等进行反映,并基于形态学及功能对下腔静脉阻塞及肝损害程度加以反映。故在下腔静脉阻塞BCS诊断中,应用64排螺旋CT具有较高的临床价值。     

下腔静脉血流速度对合理选择布-加综合征CT静脉成像延迟时间的参考价值

目的 探讨多普勒超声所测下腔静脉血流速度对合理选择布-加综合征(BCS)CT静脉成像(CTV)延迟时间的参考价值. 方法 40例DSA证实的BCS患者,介入治疗前1周内均以多普勒超声测量下腔静脉血流速度值.CTV延迟时间设定为120 s、180 s、240 s、300 s,直至获取到满意的原始图像.将最佳延迟时间与下腔静脉血流速度值进行对照分析. 结果 40例BCS下腔静脉血流速度为(3.02±6.87)cm/s,其中血流速度≤5 cm/s者6例,CTV最佳延迟时间均为300 s;血流速度>5且≤10 cm/s者22例,CTV最佳延迟时间均为240 s;血流速度>10且≤15 cm/s者11例,其中CTV最佳延迟时间180 s者8例,240 s者3例;血流速度>15 cm/s者1例,CTV最佳延迟时间120 s. 结论 多普勒超声所测下腔静脉血流速度对BCS CTV延迟时间的合理选择具有较高的参考价值.     

布-加综合征中副肝静脉的超声表现及意义

目的　探讨副肝静脉在布 加综合征中的超声表现及其临床意义。方法　超声检查 2 14例正常成人的肝右后下静脉和 2 8例布 加综合征患者的肝右后下静脉和尾状叶静脉。主要观察肝右后下静脉在正常成人和布 加综合征患者的显示率及管径 ,尾状叶静脉在布 加综合征患者的显示率及管径。结果　肝右后下静脉多在第一肝门平面注入下腔静脉。正常成人肝右后下静脉显示率为 2 4% ,平均管径为 ( 0 .43± 0 .12 )cm ;布 加综合征患者肝右后下静脉的显示率为 71% ,平均管径为 ( 0 .78± 0 .16 )cm ,两组之间的差异具有非常显著性意义 ( P <0 .0 1)。布 加综合征患者尾状叶静脉的显示率为 79% ,平均管径为 ( 0 .5 2±0 .17)cm。结论　副肝静脉的超声观测在布 加综合征诊疗中具有重要意义。     

布-加综合征的超声诊断价值

目的：评价超声检查对布-加综合征的诊断价值,探讨布-加综合征下腔静脉阻塞的超声分型。方法：对66例布-加综合征患的声像图进行分析,全部病例均经下腔静脉造影。选择性肝静脉造影证实。结果：据病因及声像图表现分为四型：膜性狭窄、膜型闭塞、节段性狭窄、瘤栓阻塞型。超声检查可显示部位、类型、范围和梗阻程度,对布-加综合征的诊断、分型及治疗方案的选择具有重要意义,是筛选和诊断布-加综合征的首选方法。     

布-加综合征合并上腔静脉阻塞诊治分析

目的探讨布一加综合征合并上腔静脉阻塞的诊断与治疗方法。方法本组3例布一加综合征术前均经腹部彩超及磁共振静脉成像检查确诊,上腔静脉阻塞经上腔静脉造影证实。3例下腔静脉均狭窄闭塞行球囊扩张成形术;例1上腔静脉入右房口处狭窄采用球囊单纯扩张,例2、3因无明显上腔静脉阻塞症状且上腔静脉完全闭塞导丝无法通过而未行介入处理。结果3例介入手术后下腔静脉压力分别由术前的23．33、25．88和17．55mmHg降至9．60、9．60和7．20mmHg。例1上腔静脉压力由术前16．58mmHg降至术后6．98mmHg。3例术后皆恢复顺利,出院。随访症状完全消失、肝肾功能恢复正常。结论对布一加综合征患者术前应充分了解上腔静脉通畅情况,避免漏诊上腔静脉阻塞。对上腔静脉阻塞症状较轻或无症状者可不予处理,症状较重者应根据病因进行治疗。     

FIESTA序列对Budd-Chiari综合征下腔静脉病变的诊断价值

目的：探讨FIESTA序列对Budd-Chiari综合征(BCS)下腔静脉病变的诊断价值。材料与方法回顾性分析51例临床诊断为BCS的患者的下腔静脉病变情况,以DSA为诊断金标准,评估FIESTA序列对下腔静脉病变的诊断能力,包括检出静脉病变的敏感度、特异度、诊断准确度,显示下腔静脉血栓、下腔静脉瘤的能力。结果 MRI诊断准确有41例,灵敏度为97.61%、特异度为55.56%、准确度为90.20%;发现下腔静脉血栓8例,下腔静脉瘤样扩张4例。结论 FIESTA序列在显示BCS的下腔静脉中具有直观、准确率较高、无需对比剂的优点,可作为诊断BCS下腔静脉病变的常规序列。     

Sonography in Budd-Chiari syndrome.

OBJECTIVE: The objective of this presentation is to provide an overview of sonographic manifestations of Budd-Chiari syndrome (BCS). METHODS: Patients were scanned with ultrasound systems using mainly a 2- to 5-MHz curvilinear transducer and in some patients a 5- to 12-MHz linear transducer. The patients were asked to fast from the previous night or for at least 6 hours. Color and spectral Doppler sonography was performed in all patients. RESULTS: Commonly seen findings in BCS include inferior vena cava (IVC) webs and thrombi, IVC narrowing, hepatic venous thrombosis, enlarged caudate lobes, ascites, intrahepatic or extrahepatic collaterals, monophasic to absent flow in the hepatic veins, and high flow velocities in areas of stenosis in the IVC or hepatic veins. Inferior vena cava stents used in the treatment of BCS could also be seen. CONCLUSIONS: Budd-Chiari syndrome is an uncommon disorder; outcome is poor in many cases; and the condition is often misdiagnosed or underdiagnosed. Sonography is a noninvasive and effective modality for diagnosis of BCS.     

Fracture of inferior vena cava stent after endovascular treatment for Budd-Chiari syndrome: A case series and literature review

Budd-Chiari syndrome (BCS) is a rare condition characterized by hepatic venous outflow obstruction. Balloon angioplasty, with or without stenting, is the recommended first-line treatment modality in Asian countries. As a supplement to balloon angioplasty, expandable metallic Z-stent deployment can effectively improve long-term inferior vena cava (IVC) patency. Although stent placement is a standard and frequently performed treatment, very few IVC stent-related complications, such as stent fractures, have been reported. Here we present a case series and a comprehensive review of IVC stent fractures in patients with BCS. The most common characteristic of IVC stent fractures is a protrusion of the proximal segment of the IVC stent into the right atrium and its systolic and diastolic movements along with heart rhythms. Accurate stent deployment, large-diameter balloon dilation, patient breath-holding training, preferential selection of a triple stent, and the use of an internal jugular vein approach to stent deployment may ensure precise stent localization and avoid postoperative complications.     

Budd-Chiari综合征患者下腔静脉病变介入治疗后复发的超声表现

介入技术是治疗Budd-Chiari综合征(Budd-Chiari syndrome, BCS)的有效手段,但有一定的复发率.本文通过分析BCS复发患者下腔静脉(inferior vena cava,IVC)病变治疗前、治疗时的超声影像特点,旨在探讨复发相关因素.     

Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Bilateral proximal deep vein thrombosis (DVT) in the lower extremities of young patients should raise suspicion over pro‐thrombotic conditions and venous anatomical abnormalities, even in the presence of other precipitating factors, such as viral infection. The authors present a 33‐year‐old man with bilateral DVT and absence of inferior vena cava (AIVC), who also had concurrent COVID‐19, and discuss the management of this patient.     

Relief of Budd-Chiari syndrome by primary placement of a metallic stent in the inferior vena cava: Case report

Summary. A case of Budd-Chiari syndrome with associated lower limb oedema due to concomitant inferior vena caval and hepatic venous thrombosis is presented. Percutaneous placement of a Wallstent through the occluded vena cava resulted in resolution of both the lower limb oedema and the hepatic vein thrombosis. In this instance recannalization of the inferior vena cava alone resulted in improvement of his liver function.     

Compression of left inferior vena cava: a form of nutcracker syndrome

Left renal vein hypertension has been described in the literature as a cause of persistent hematuria. We report a case of nutcracker syndrome with hematuria involving the left inferior vena cava diagnosed with Doppler sonography and MRI.     

Single ventricle and single atrium with anomalous hepatic venous drainage and azygos continuation of inferior vena cava in an adult patient

In a 37‐year‐old patient, ultrasonography showed and CT confirmed the presence of single ventricle, single atrium, azygos continuation of inferior vena cava, anomalous hepatic vein drainage, and persistent left superior vena cava. Such a constellation of cardiovascular anomalies is exceptionally diagnosed in adulthood. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43 :458–461, 2015