肝静脉膜性阻塞的下腔静脉造影征象与破膜术

目的：评价ＢＣＳ行下腔静脉造影中见到的一种征象用于诊断肝静脉口部膜性阻塞及策 膜。资料与方法：对１７例拟诊ＢＣＳ的病人做了下腔静脉造影,其中５例肝静脉膜性阻塞者经颈静脉或股静脉,用下腔静脉造影所示“乳头征”或结合榱超声引导穿刺针破膜,行肝静脉测压、造形及球囊扩张。结果：５例肝静脉膜性是腔静脉造都以壁向腔内的 节状充盈缺损。经腔静脉穿刺破膜均获成功。肝静脉造影证实口部膜性阻塞。球畜牧一重建了肝静脉流

A Sign on venacavogram for diagnosis and recanalization of hepatic vein occlusion

Purpose: To evaluate a sign showed in venacavography for diagnosis and guidance of the intervention in BCS with web obstruction of hepatic vem ostium. Materials and methords: 17 cases suspected with BCS received inferior venacavography, in which 5 web obstruction of hepatic vein, which were revealed "nodular feeling defect" in the venacavography were recanalized via jugular or fe-maral vein followed by venogrphy and balloon dilatation, underthe guidanc of the venacavography or/ and sonography. Results: Besides incomplete obstruction of the IVC, 5 cases were presented a nodular feeling defect' in venacavogram and the recanalization of hepatic vein were successful by puncture. Hepatovenography demonstrated the web obstruction covered the hepatic vein ostium with a convex toward IVC. Re- establishments of hepatic vein outflow was successful which reduced pressure of hepatic vein for 1.84kPa in average. Conclusion: A nodular sign on venacavograph indicates the membranous obstruction of hepatic vein ostium, which is considered a mark for puncture to recanalize hepatic vein.