中国河南地区布加氏综合征患者肝内静脉及侧支循环的超声表现分析

目的：探讨中国河南地区布加氏综合征（Budd-Chiari syndrome, BCS）患者肝内静脉及侧支循环的超声影像表现特点。方法：分析567例BCS患者肝内静脉及侧支循环的超声图像资料。结果：①肝左静脉（LHV）病变507例，肝中静脉（MHV）病变517例，肝右静脉（RHV）病变418例。LHV、MHV以膜性闭塞性病变最多，RHV以条索状闭塞最多。②567例BCS患者副肝静脉（AHVs）扩张403例，病变27例，AHVs有病变与无病变在下腔静脉（IVC）是否病变方面差异有统计学意义（P=0.000，连续校正法）。③肝内侧支循环类型8种。④567例BCS患者中395例肝内形成侧支循环，尾叶静脉与肝右后静脉在与主肝静脉（MHVs）形成侧支方面有统计学差异（P=0.000）。⑤病变的LHV、MHV、RHV形成侧支循环例数分别为331、319、104例，三者在形成侧支循环方面有统计学差异（P=0.000），两两比较：LHV与MHV在形成侧支循环方面无统计学差异（P=0.234），LHV与RHV及MHV与RHV在形成侧支循环方面有统计学差异（P=0.000）。结论：①中国河南地区BCS患者MHVs病变发生率高，多伴有副肝静脉代偿扩张及侧支循环形成。②BCS患者肝内侧支循环类型丰富，尾叶静脉与MHVs形成侧支循环数量明显多于肝右后静脉；LHV、MHV侧支循环形成数量多于RHV，MHVs病变主要类型与侧支循环形成多少有关。③AHVs有一定的病变率，IVC病变不是AHVs病变的主要诱因。

Ultrasonic features of hepatic veins and collateral circulations in Budd-Chiari syndrome in Henan Province

Objective： To investigate ultrasonic imaging features of hepatic veins and collateral circulations in Budd-Chiari syndrome （BCS） in Henan Province. Methods： Sonograms of 567 patients with BCS were analyzed. Results： （1）There were 517 branches of middle hepatic vein （MHV） had pathological changes, 507 branches of left hepatic vein （LHV） had pathological changes and 418 branches of right hepatic vein （RHV） had pathological changes. The main lesion type of LHV and MHV was membranous occlusion. The main lesion type of RHV was streak-like stenosis. （2）There were 403 patients with dilated acces- sary hepatic veins （AHVs） in 567 patients with BCS. In them, there were 27 branches with pathological changes. There was a significant difference in AHVs with or without pathological changes between unobstructed inferior vena cava（IVC） and obstruct- ed IVC（P=-0.000, continuity correction）. （3）There were 8 types of collateral circulation. （2）There were 395 patients with collateral circulation wiehin liver in 567 patients with BCS. There was a significant difference in collateral circulation with MHYs between caudate lobe veins and right posterior veins （P=0.000）. @There were 331 branches of LHV with collateral circulation, 319 branches of MHV with collateral circulation and 104 branches of RHV with collateral circulation. There was a significant difference in collateral circulation between LHV, MHV and RHV （P=0.000）. There was no a significant difference in collateral circulation between LHV and MHV （P=0.234）. There was a significant difference, in collateral circulation between LHV and RHV（P=0.000）. There was a significant difference in collateral circulation between MHV and RHV（P=0.000）. Conclusions： （1） The features of MHVs of BCS in Henan Province of China which had a high affection rate, more dilated AHVs and collateral circulations in liver. （2）There are abundant types of collateral circulation in liver of patients with BCS. There are more collateral circulations between caudate lobe veins and MHVs than that between right posterior veins and MHVs. There are more collateral circulations of LHV and MHV than that of RHV. The main affection category of MHVs concerned with quantity of collateral circulation. （3）Some AHVs have pathological changes. The affection of IVC is not the major factor for AHVs.